Case Manager II, Acute

Sutter Health•Berkeley, CA

1d•$59 - $79

About The Position

The Case Manager II position plays a critical role in the central intake department, specifically in admissions to Herrick's psychiatric hospital. This role involves reviewing, assessing, and presenting psychiatric cases for admission to Herrick's four psychiatric units. The position is responsible for utilization management, resource management, discharge planning, post-acute care referrals, and care facilitation. It oversees the management of acute patient populations across the care continuum, aiming to provide coordinated and integrated care to prevent unnecessary admissions or readmissions. The role includes providing discharge planning coordination and intervention for high-risk patients presenting to the Emergency Department. The ultimate goal is to promote patient wellness, improve care outcomes, ensure efficient utilization of health services, and minimize payment denials for patients with complex health needs.

Requirements

Master's degree in Social Work or related field, or equivalent experience.
2 years recent relevant experience.
Broad knowledge base of health care delivery and case management within a managed care environment.
Comprehensive knowledge of Utilization Review, levels of care, and observation status.
Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to CMS, Title 22 CHA Consent Manual, CDPH and The Joint Commission (TJC).
Broad knowledge base of post-acute levels of care and associated regulatory compliance requirements.
Ability to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
Demonstrates commitment to service excellence in all patient, family and employee interactions and in performing all job responsibilities.
Functions in a manner to promote quality patient care and assure a positive patient experience.
Verbal and written communication skills.
Interpersonal communication and negotiation skills.
Time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
Intermediate computer skills.
Ability to promote teamwork and to effectively function in teams.
Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience.

Responsibilities

Reviews, assesses and presents psychiatric cases for admission to Herrick's four psychiatric units.
Coordinates utilization management, resource management, discharge planning, post-acute care referrals and care facilitation.
Oversees the management of acute patient populations across the care continuum with a focus to provide coordinated and integrated care to prevent unnecessary admissions or readmissions.
Provides discharge planning coordination and intervention for the high risk patient presenting to the Emergency Department.
Strives to promote patient wellness, improved care outcomes, efficient utilization of health services and minimized denials of payment among a patient population with complex health needs.