Case Manager (RN) - Inpatient - 1.0 FTE, 8-hr, Day Shift

Stanford Health Care•Woodside, CA

13d•$96 - $111•Onsite

About The Position

Case Managers are licensed nursing professionals responsible for coordinating continuum-of-care and discharge-planning activities for an assigned caseload of patients. They coordinate admission and discharge, conduct utilization reviews, and help ensure appropriate use of services, effective resource allocation, and compliance with external review requirements. They consult with clinical teams, service lines, and other departments on patient assessment and care, and contribute to program development and quality improvement. Through application of guidelines and collaboration with multidisciplinary teams, they influence the delivery and quality of patient care. The hospital-based case management system aims to ensure appropriate use of services, avoid duplication or misuse, control costs, and improve care delivery. Its objectives include timely discharge, efficient use of resources, achievement of expected outcomes, collaborative practice, care coordination across the continuum, and quality improvement that supports optimal patient outcomes. The role does not provide direct patient care; instead, Case Managers ensure that required medical services and treatments are delivered in a financially and clinically efficient manner. This position is based at Stanford Health Care in Palo Alto or Redwood City, California, and is onsite, full-time, with an eight-hour day shift. The role requires a California Registered Nurse license and a bachelor's degree. A master's degree is preferred.

Requirements

Bachelor's degree from an accredited college or university.
Three years of progressively responsible and directly related work experience.
California Registered Nurse (CA-RN) license.
Ability to collect and record data, evaluate data and statistics, and maintain effective reporting systems.
Ability to develop and perform patient assessments and plans of care.
Ability to monitor and ensure patient access to the appropriate level of care, providers, setting, and services, and to promote coordination and continuity of health care.
Ability to provide age-appropriate assessments, interpret data, and deliver interventions.
Ability to provide appropriate patient care and clinical information when patients are admitted, referred, transferred, or discharged.
Ability to remain knowledgeable about available treatments and services.
Ability to resolve conflicts or negotiate to achieve positive results and establish and maintain effective interpersonal relationships.
Ability to understand, interpret, and apply complex federal and state hospital compliance laws, rules, regulations, and guidelines.
Ability to work effectively with individuals at all levels of the organization.
Knowledge of available patient services and treatments; nursing and health-care theories, principles, practices, standards, emerging technologies, techniques, and approaches; and professional responsibility and accountability for practice outcomes.
Knowledge of evaluation and assessment techniques, health-care funding processes, hospital operations and California hospital laws and regulations, medical terminology and levels of care and treatment, the continuum of care and integration of its components, case-management models and practices, and variables affecting patient-care processes and outcomes.

Nice To Haves

Master's degree.

Responsibilities

Coordinate each assigned patient's transition through the system and transfer accountability to the appropriate person when the patient enters another clinical service or is discharged.
Coordinate and facilitate timely discharge plans for assigned patients with complex needs, collaborating with interdisciplinary team members and arranging follow-up care as appropriate.
Review inpatient admissions, level of care, and length of stay prospectively, concurrently, and retrospectively; monitor length of stay and collaborate with physicians to ensure resource use is appropriate to covered benefits and patients' clinical and psychosocial needs.
Plan and implement strategies through multidisciplinary meetings or rounds to reduce length of stay and resource consumption and achieve positive patient outcomes; analyze individual and aggregate variances and share findings with staff, physicians, and administration.
Educate and consult with patients, families, and hospital medical personnel about discharge planning and applicable regulatory requirements; educate staff about case management and provide information related to specific case types.
May lead administrative or clinical support staff assisting with case management for an assigned patient caseload.
Participate in department program planning, goal setting, systems development, process improvement, and department or hospital committees and task forces.
Document findings, discharge arrangements, and actions taken according to departmental guidelines; maintain required records and collect, analyze, and report data for utilization, quality improvement, compliance, and other assigned areas.
Collaborate with physicians, social workers, nurses, and other interdisciplinary team members to assess, plan, and coordinate patient care needs, and/or perform patient assessments and develop plans of care.
Participate in quality improvement activities, identify opportunities related to clinical outcomes and resource utilization, collect concurrent data, and participate in clinical process improvement teams.
Collect, analyze, report, and review patient information with third-party payers, and communicate requested clinical and psychosocial information to review organizations and payers to support reimbursement for services and procedures.