Case Manager II NE

Kindred Healthcare•West Covina, CA

3d•$47 - $58•Onsite

About The Position

Kindred Hospital San Gabriel Valley is a 76-bed long-term acute care hospital offering extended recovery period care. They partner with physicians and offer 24-hour clinical care seven days a week. This role coordinates and facilitates patient care through collaboration with the Interdisciplinary Care Transitions (ICT) team. The position ensures optimum utilization of resources, service delivery, and compliance with external review agencies. It provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation, and evaluation of individual patient needs. The goal is to enhance patient management and satisfaction, promote continuity of care, and ensure cost-effectiveness by integrating case management, utilization review, and discharge planning functions.

Requirements

Postsecondary (Cert/Diploma/Program Grad) from an accredited school of nursing (Required)
RN - Registered Nurse - State Licensure and/or Compact State Licensure in the state of practice Upon Hire (Required)
LCSW- License Clinical Social Worker LCSW or LSW Upon Hire (Required)
2+ years experience in healthcare setting (Required)
Knowledge of government and non-government payor practices, regulations, standards and reimbursement.
Knowledge of Medicare benefits and insurance processes and contracts.
Knowledge of accreditation standards and compliance requirements.
Ability to demonstrate critical thinking, appropriate prioritization and time management skills.
Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheet software.
Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers
Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members.
Must read, write and speak fluent English.
Must have good and regular attendance.

Nice To Haves

Bachelor’s Degree in nursing or social work: BSN, MSN, BSW or MSW (Preferred)
CSWCM - Social Work Case Manager Certification Upon Hire (Preferred)
Prior Experience in case management, utilization review, or discharge planning (Preferred)

Responsibilities

Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
Monitors all areas of patients’ stay for effective care coordination and efficient care facilitation.
Remains current regarding reimbursement modalities, community resources, case management, psychosocial and legal issues.
Appropriately refers high risk patients who would benefit from additional support.
Serves as a patient advocate.
Enhances a collaborative relationship to maximize the patient’s and family’s ability to make informed decisions.
Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care.
Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post hospital needs.
Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals.
Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in the planning of the patients’ care throughout the care continuum.
Conducts comprehensive, ongoing assessment of patients to provide timely and safe discharge planning.
Provide comprehensive discharge planning for each patient.
Utilizes critical thinking to develop and execute effective discharge planning.
Coordinate and communicates with patient/family efficient and effectively.
Conducts medical necessity review for appropriate utilization of services from admission through discharge.
Promotes effective and efficient utilization of clinical resources.
Conducts timely and accurate clinical reviews, care collaboration and coordination of continued stay authorization with payor.
Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
Serves on Hospital and Division committees when requested.
Performs other related duties as assigned.