SNF Placement Case Manager, Rn/Lvn
Northridge , CA 91324
Posted 2 months ago
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As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.We currently have an opening for an SNF Placement Case Manager:The SNF Placement Case Manager performs triage functions by providing support and guidance, to After Hours team by assisting with transferring patients from Acute setting to SNF, Sub-acute, Congregate Livings and/or Recuperative Care Centers. Afterhours SPT Case Manager responds to and coordinate service request for transfers, request for SNF/Sub-acute/Recuperative Care admissions and facilitate discharges to lower levels of care to prevent additional bed days in Acute and delay of transfers. Demonstrates self-direction in establishing priorities and working with routine supervision. Working collaboratively with After Hours SPT Coordinator and After Hours Team after business hours and weekends. Maintains high level of precision in judgment, accuracy of assessment, and skill in problem solving under stress. Relates and communicates well over the telephone to all callers.* Facilitates transition of members from Acute setting to Skilled Nursing Facilities, Sub-Acute Facilities, Congregate Livings and Recuperative Care Centers. * Communicate with After Hours Inpatient team * Clinical review of SNF placement requests and clinical progress notes * Receives, triages, and responds to telephone calls from facilities requiring medical and nursing inquiries * Performs comprehensive review of clinical records, history & physical, evaluation of Skilled need and advice while meeting production standards. * Assesses patient problems utilizing approved MCG guidelines, directing access to care to include Skilled Nursing Facilities, Sub-acute Facilities, Congregate Livings and Recuperative Care Centers * Follows established clinical protocols/guidelines * Directs patient to appropriate levels of care based on assessment within the established guidelines. * Communicates to After Hours Management and escalate issues as necessary * Facilitates authorizations for vendors and/or outside services as appropriate. * Obtain LOA for non-contracted facilities as needed * Documents all calls according to established standards in REA/LEA* Documents all SNF inquiries and member disposition in the SNF Placement Team log daily * Participates in quality monitoring process by daily verbal endorsement between SNF Placement Team business hours and After Hours Team * Translates oral information into concise and accurate written documentation using standard medical guidelines and abbreviations. * Shift summary to be sent to the Director, Manager and Lead of SNF Department * Recognizes financial, medical and legal risks based on data collected during customer interactions and follows appropriate procedures. * Demonstrates customer service-oriented behavior at all times. * Acts as a mentor as requested by supervisor. * Expedites emergency calls as needed. * Participates in regular staff meetings as scheduled. * Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. * Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality, care and concern with each and every internal and external customer. * Performs additional duties as assigned. * Adheres to Code of ConductSkills * Good judgment and critical-thinking skill * Compassionate and caring manner with patients * Telephone "charisma"* Forms instant rapport * Customer serviceoriented * Helpful, warm, open, and inviting * Excellent communication skills (written, verbal, and technical)* Articulate * Able to communicate well at fifth- to eighth-grade level * Bilingual language skills a plus * Concise, clear documentation skills * Excellent listening skills * Excellent negotiation skills * High levels of experience or expertise in: * Crisis intervention * Teaching/coaching * Disease management * Discharge Planning * Attributes* Functions well in a high-stress environment and under time pressure * Tolerates ambiguity well * Works well independently * Works effectively with: * Culturally diverse populations * Educationally diverse and illiterate populations * Non-English-speaking populations * High-risk populations *Must be available to work in Northridge, CA, M-F, 8-5.We offer a full benefits package which includes employer paid medical, pharmacy and dental benefits. We offer a generous PTO package, 401k Retirement Savings, Life Insurance, Flexible Spending Account (FSA), Tuition Reimbursement & Licensed Renewal Fees for our clinical staff.Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.