Inpatient Case Manager ED, NBMC (Full Time, Days)

NorthBay Health•Fairfield, CA

14h•Onsite

About The Position

At NorthBay Health the Emergency Department Case Manager (EDCM) is to assess, plan, implement, monitor and evaluate options and services to affect an appropriate, individualized plan for patient care in the Emergency Department (ED) and extending across the continuum of care. The EDCM ensure patients are transitioned to optimal level of care as quickly as possible. The EDCM make recommendations to the Interdisciplinary Care Team on continued patient needs from a utilization and case management perspective and effectively communicates and collaborates with the patient, family, physician(s), nursing, and other health care team members to coordinate post ED care. Using independent judgment and discretion, the patient must be assessed and reassessed as an ongoing process to address the patient’s broad spectrum of needs through the ED episode. The EDCM utilize clinical knowledge and competence, positive communication skills, problem solving and conflict resolution techniques, ability to effect change, strong skills in assessment, organization, and time management. The case management process requires a focus on critical thinking skills, customer service skills, setting appropriate goals and measuring outcomes to effectively ensure optimal patient outcomes with consideration to financial and healthplan resources. The EDCM communicate appropriate information to care providers in the continuum of care, monitors/reports ED utilization trends and intervenes as appropriate to ensure patients are connected with available resources. Documents assessment and interventions in Cerner. Collaborates with the Patient Placement Coordinators/Administrative Coordinators in verifying medical necessity and insurance contract compatibility prior to a bed assignment for admitted patients from the ED. Uses MCG criteria to assess appropriate level of care and medical necessity for admission/observation status. Assesses patients based on age and development stage utilizing resources needed for both care and financing. The EDCM will coordinate transfers into the appropriate facility at the correct level of care ensuring that continued hospitalization is warranted, contracted, and appropriate. The EDCM at NorthBay Healthcare must be able to demonstrate and be accountable for the policies, procedures, quality assurance, guidelines and goals of the department and the organization. The EDCM will provide assistance to coworkers in the inpatient setting as able and/or as directed by the Supervisor, or designee. The EDCM work under the direction of Inpatient Case Management Supervisor or designee. Interpersonal Skills and Values Demonstrates NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care. Why NorthBay Health NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics. We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions. We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities. NorthBay Health Benefits Options NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance. Compensation Structure NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements. Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs. Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States. Notice to Recruitment Agencies NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings. More Information Visit NorthBay Health Careers for recruitment FAQs [https://www.northbay.org/careers/recruitment-faq.html] and additional information.

Requirements

clinical knowledge and competence
positive communication skills
problem solving and conflict resolution techniques
ability to effect change
strong skills in assessment, organization, and time management
focus on critical thinking skills
customer service skills
setting appropriate goals and measuring outcomes
knowledge of financial and healthplan resources

Responsibilities

assess
plan
implement
monitor and evaluate options and services to affect an appropriate, individualized plan for patient care in the Emergency Department (ED) and extending across the continuum of care
ensure patients are transitioned to optimal level of care as quickly as possible
make recommendations to the Interdisciplinary Care Team on continued patient needs from a utilization and case management perspective
effectively communicates and collaborates with the patient, family, physician(s), nursing, and other health care team members to coordinate post ED care
assess and reassess patient needs
communicate appropriate information to care providers in the continuum of care
monitors/reports ED utilization trends and intervenes as appropriate to ensure patients are connected with available resources
Documents assessment and interventions in Cerner
Collaborates with the Patient Placement Coordinators/Administrative Coordinators in verifying medical necessity and insurance contract compatibility prior to a bed assignment for admitted patients from the ED
Uses MCG criteria to assess appropriate level of care and medical necessity for admission/observation status
Assesses patients based on age and development stage utilizing resources needed for both care and financing
coordinate transfers into the appropriate facility at the correct level of care ensuring that continued hospitalization is warranted, contracted, and appropriate
demonstrate and be accountable for the policies, procedures, quality assurance, guidelines and goals of the department and the organization
provide assistance to coworkers in the inpatient setting as able and/or as directed by the Supervisor, or designee

Benefits

medical, dental, and vision insurance
life, disability, and long-term care coverage
paid time off including vacation, sick leave, holidays, and bereavement
a 403(b) retirement plan with employer match
education reimbursement for eligible roles
professional development and training programs
Employee Assistance Program
wellness programs
recognition programs
shift differentials
market-based compensation review and increases subject to approval and organizational performance