Case Manager

PACS

10d

About The Position

The Case Manager uses critical thinking and care coordination expertise to collaborate with residents, their families or significant others, healthcare providers, insurers, community resources, and other involved parties. The role develops and implements plans of care that provide extraordinary care while remaining sensitive to costs and resources. The position coordinates resident care, utilization review, admissions, discharges, and referrals. It communicates with residents and families about plans of care and treatment, answers questions, monitors changing needs, maintains documentation, and promotes effective collaboration among care partners. The role has no supervisory responsibilities.

Requirements

Prior experience in healthcare, case management, or social services is strongly preferred.
Knowledge of Medicare, Medi-Cal, and Medicaid programs and benefits.
Strong communication skills, including the ability to read and comprehend policy and procedure manuals and present information effectively to residents, families, and staff.
Ability to organize, prioritize, and manage multiple tasks in a fast-paced environment.
Compassionate, professional demeanor and commitment to resident-centered care.
Ability to read technical procedures and policy and procedure manuals, and to present information and respond to questions from managers and employees.
Ability to apply fractions, percentages, ratios, and proportions to practical situations.
Ability to solve practical problems and interpret written, oral, diagrammatic, or scheduled instructions.
Primarily sedentary work involving frequent sitting, computer use, and documentation; regular walking throughout the facility; occasional standing during meetings and care conferences; ability to lift and carry up to 20 pounds; and clear verbal communication and vision for chart review and resident interaction.

Nice To Haves

Bachelor’s degree in Social Work, Human Services, Nursing, or a related field preferred; non-licensed candidates accepted.
Familiarity with PCC (PointClickCare) or other electronic medical record systems preferred.
Certified Case Manager (CCM) certificate is a plus.

Responsibilities

Communicate regularly with residents and families about plans of care, PT, OT, and other treatment protocols.
Attend and participate in morning meetings or stand-ups to facilitate team communication.
Answer residents’ questions about their care, treatment plans, illness progression, and related concerns.
Monitor and adjust residents’ statuses in response to changing needs and conditions.
Organize and prioritize daily work by assessing the needs of new, current, and discharging residents in areas of responsibility.
Complete required documentation and ensure accurate charting and timely paperwork.
Perform utilization review activities to support appropriate, timely, and cost-effective care.
Coordinate care with residents, care providers, facility financial services, and third-party payers.
Oversee admissions and discharge activities.
Coordinate referrals to and from the facility.
Build positive and effective working relationships with residents, families, staff, and professional colleagues.
Work independently and exercise sound judgment in interactions with physicians, providers, payers, residents, and families.
Communicate effectively and promote cooperation among residents, families, caretakers, physicians, nurses, and ancillary partners.
Manage time and organize work effectively in a high-volume environment with changing priorities.
Use intermediate computer skills.
Maintain professional, respectful, and honest interactions with residents, families, staff, and partners.