Case Manager, RN - Per Diem

Salinas Valley Health•Salinas, CA

1d•$89 - $103

About The Position

Under the direction of the Director and/or Manager of Case Management, the Case Manager performs utilization review and discharge planning for assigned patients. The role analyzes medical records for medical necessity, level of care, and appropriate utilization of hospital services; assists patients and families with discharge and aftercare planning; assesses needs and identifies resources to support discharge requirements; and develops formal discharge plans. The Case Manager promotes continuity of care, refers cases that do not meet utilization screening criteria to physician reviewers, determines and monitors appropriate length of stay, collaborates with hospital personnel to manage care delivery, screens patients for potential discharge needs, initiates discharge planning and teaching, and identifies resources for follow-up care while evaluating discharge-planning effectiveness. For NICU patients, the Case Manager helps ensure appropriate discharge information, follow-up with a primary care physician, and access to specialized High Risk Infant follow-up when appropriate. The role assesses eligibility for high-risk follow-up, informs parents or guardians about the process, arranges specialty clinic appointments and ordered durable medical equipment, facilitates a home health nursing visit after discharge, and refers qualifying infants to CCS while explaining the referral process. Under the direction of the Director of Case Management, the role develops and implements neonatal-unit discharge-planning standards and maintains expertise through literature review and conference attendance or presentations. For pediatric patients, the Case Manager ensures appropriate discharge information and communication with primary care physicians, community agencies, CCS programs, CCS Special Care Centers, and Regional Centers as appropriate. The role ensures caregivers receive culturally and linguistically appropriate written discharge instructions covering diagnosis, medications, follow-up appointments, and home medical-treatment instructions, and that copies are provided to the primary physician. The Case Manager teaches caregivers about the patient's medical needs and any technology needed for post-discharge care, and coordinates appropriate multidisciplinary team members in discharge-planning conferences. Other duties may be assigned.

Requirements

Associate of Science in Nursing (ASN) required.
Current California RN license required.
Current BLS/Healthcare Provider status according to American Heart Association standards required.
Three years of acute medical-surgical nursing experience required.
At least one year of utilization review, case management, or discharge-planning experience in an acute-care hospital required, unless the posting specifies a training position.

Nice To Haves

Bachelor of Science in Nursing (BSN) preferred.

Responsibilities

Perform utilization review and discharge planning for assigned patients.
Analyze medical records for medical necessity, level of care, and appropriate utilization of hospital services.
Assist patients and families with discharge and aftercare planning; assess needs, identify resources, and develop formal discharge plans.
Promote continuity of care and refer cases that do not meet utilization screening criteria to physician reviewers.
Determine and monitor appropriate length of stay.
Collaborate with hospital personnel to manage care delivery.
Screen patients for potential discharge needs, initiate discharge planning and teaching, identify follow-up resources, and evaluate the effectiveness of discharge planning.
For NICU patients, ensure appropriate discharge information, primary-care follow-up, and access to specialized High Risk Infant follow-up when appropriate; assess eligibility and advise parents or guardians about the process.
Arrange NICU specialty-clinic appointments and physician-ordered durable medical equipment, facilitate a post-discharge home health nursing visit, and refer qualifying infants to CCS while explaining the referral process.
Develop and implement neonatal-unit discharge-planning standards under the direction of the Director of Case Management.
Maintain neonatal discharge-planning expertise by reviewing literature and attending and/or presenting at conferences.
For pediatric patients, coordinate communication and appropriate referrals to primary care physicians, community agencies, CCS programs, CCS Special Care Centers, and Regional Centers.
Ensure caregivers receive culturally and linguistically appropriate written discharge instructions, including diagnosis, medications, follow-up appointments, and home-treatment instructions; provide copies to the primary physician.
Teach caregivers about the patient's medical needs and technology required for post-discharge care.
Coordinate appropriate multidisciplinary team members in infant, pediatric, and/or adolescent discharge-planning conferences.
Perform other duties as assigned.