RN / LVN SNF Case Manager

Regal Medical Group•Los Angeles, CA

11d•$38 - $50

About The Position

The SNF Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk patients. The SNF Case Manager will assess and develop a care plan in collaboration with the admitting, attending and consulting physician and other health care practitioners. The goal of the SNF Case Manager is to effectively manage patients on an outpatient basis to assure the right level-of-care is provided, to prevent inpatient re-admissions and ensure that the patients’ medical, environmental and psychosocial needs are met over the continuum of care.

Requirements

RN License or LVN License
3 years acute care experience
Knowledge in MS Office Programs (ie Word, Excel, Outlook, Access and PowerPoint
Knowledge of computers, faxes, printers and all other office equipment
Typing 40 words per minute with accuracy

Nice To Haves

2-3 years of utilization or HMO experience preferred

Responsibilities

Keeps patient/family members or other customers informed and requests if necessary, further assistance when needed.
Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner.
Participates in “service recovery” through follow-up with the injured party, gathering information, and demonstrates empathy.
Functions as liaison between administration, patients, physicians and other healthcare providers.
Interacts professionally with patient/family/physicians and involves patient/family/physicians in formation of the plan of care.
Communicates appropriately and clearly to management, co-workers, and physicians
Identifies and addresses psychosocial needs of the patients and family and facilitates consultations with Social Worker, as necessary.
Receives and reviews physician’s orders; documents completion. Follows, consults with other departments as appropriate to provide for an interdisciplinary approach to the patients need.
Formulates an outcome-based plan or care, based on assessed patient needs, implements and evaluates plan as evidenced by documentation.
Maintains quality monitors as assigned by supervisor.
Documents patient assessment and reassessment, patient care plans, and other pertinent information completed in the patient’s medical record in accordance with nursing standards and policies.
Identifies community resources to address needs to cover through patient’s benefit plans.
Participates in the efficient, effective and responsible use or resources such as supplies and equipment.
Responsible for the coordination and facilitation of patient and family conferences as determined by assessment of patients’ needs.
Responsible for the coordination of post-discharge clinic appointments, medication reconciliation, PCP and SPC visits.
Identifies non-compliant members eligible for health plan dis-enrollment.
Ability to collaborate and communicate with all members of the healthcare team (concurrent review, pre-auth, PCP/SPC, Social Services) to coordinate the continuum of care of developing plans for management of each case.
Responsible for the identifying patients that are appropriate for hospice conversion or Palliative care.
May also be responsible for co-management and discharge planning of patients in the skilled setting with assigned SNF physician. Including the regulatory compliance requirements and coverage notices.
Demonstrates the ability to formulate and appropriate outpatient care plan, based on a telephonic assessment of patients needs and symptoms which addresses all key symptoms in order to effectively manage the patient on an outpatient basis.
Other duties as assigned.