CASE MANAGER- FT

TOTALLY KIDS REHABILITATION HOSPITAL•Loma Linda, CA

1d•$48 - $53•Onsite

About The Position

Totally Kids Rehabilitation Hospital is dedicated to enriching the health and quality of life of children with medical and developmental needs and who benefit from habilitation and rehabilitation services and the supportive use of patient care technology. We are committed to meeting their medical, physical, developmental, social, psychological and spiritual needs through a blend of tenderness and expertise. Totally Kids Rehabilitation Hospital has a position available for a Case Manager/Case Finder. The Case Manager/Case Finder acts as a liaison between the patient, family members, interdisciplinary team and community to assure that services provided meet the patients needs are initiated and met in accordance with their plan of care and treatment. Acts as a community liaison with hospital staff, insurance companies, other payors, physicians, and other providers to inform of services offered. Participates and communicates with billing department in obtaining authorization for admissions, services provided, and outpatient services. Coordinates and participates with Marketing on any vendor marketing activity representing Totally Kids Rehabilitation Hospital. It is expected that the employee will demonstrate behavior consistent with the Core Values. The employee shall support the organization strategic plan, the goals and direction of the quality assurance performance improvement process, and activities.

Requirements

Current California Registered Nurse (RN) Licensure
Bachelors of Science degree in nursing or related field required.
Current basic cardiac life support (BCLS) certification
Minimum of (2) years of acute or subacute nursing experience required.
Knowledge of case management theory/practice and with current psychosocial issues within the community and healthcare environment
Must possess good work ethics and a professional image at all times
Knowledge of CMS conditions of participation, CDPH state regulations, CCS, and TJC (hospital, nursing care center, and laboratory) accreditation requirements as applicable to job
Working knowledge of computer and software applications as applicable to job
Possess strong communication, interpersonal and collaboration skills
Works responsibly in a team environment as well as independently
Manages confidential information effectively and appropriately
Demonstrates knowledge of current practice and the roles and functions of patient care team members as applicable to job
Ensures compliance with the state and federal regulatory agency standards, and policies of the organization
Adheres to professional association standards of practice as applicable to job
Supports the development of an organization-wide patient safety program
Maintains and ensures patient confidentiality at all times.
Knowledge of the organizations quality assurance performance improvement (QAPI) program
Demonstrates effective interpersonal communication skills
Provides communications that is clear and effective.
Uses positive verbal/nonverbal communications
Builds collaborative relationships in the organization
Exhibits effective conflict resolution skills
Holds self and others accountable for mutual professional expectations and outcomes
Adheres to the organizations professional attire (dress code) policy
Treats our customers with respect and courtesy. Keeping their information confidential.
Demonstrates a behavior which is always willing to assist
Complies with the organizations code of conduct and compliance standards
Maintains proper use of timekeeping system to record time
Maintains professional license and/or certification as applicable to job
Acts on feedback about personal strengths and weaknesses
Completes annual organization education requirements
Completes annual employee health requirements
Consistently reliable, truthful and honest
Ability to hear and convey important and difficult information up and down the organization
Maintains a level of competency to provide reliable positive outcomes in areas of responsibility

Nice To Haves

Masters degree in related field preferred
Clinical experience in nursing care of the medically complex and/or in pediatric care preferred
Certification in Case Management or ability to achieve certification in Case Management is preferred

Responsibilities

Utilizes clinical expertise, discretion, and independent judgment in assessing, providing, coordinating and monitoring healthcare services for all assigned patients.
Ensures medical appropriateness criteria (medical necessity) met for level of care provided in the acute and subacute units and documented from admission through discharge including readmissions.
Coordinates and participates in patient discharge teaching as appropriate.
Acts as a community liaison with hospital staff, insurance companies, other payors, physicians, and other providers to inform of services offered.
Participates and communicates with billing department in obtaining authorization for admissions, services provided, and outpatient services.
Coordinates and participates with Marketing on any vendor marketing activity representing Totally Kids Rehabilitation Hospital.