SNF Placement Case Manager (LVN, RN - Part Time)

Regal Medical Group • Los Angeles, CA

93d • $37 - $50

About The Position

The SNF Placement Team (SPT) Case Manager performs triage functions by providing support and guidance, to After Hours team by assisting with transferring patients from Acute setting to SNF, Sub-acute, Congregate Livings and/or Recuperative Care Centers. Afterhours SPT Case Manager responds to and coordinate service request for transfers, request for SNF/Sub-acute/Recuperative Care admissions and facilitate discharges to lower levels of care to prevent additional bed days in Acute and delay of transfers. Demonstrates self-direction in establishing priorities and working with routine supervision. Working collaboratively with After Hours SPT Coordinator and After Hours Team after business hours and weekends. Maintains high level of precision in judgment, accuracy of assessment, and skill in problem solving under stress. Relates and communicates well over the telephone to all callers.

Requirements

• Graduate of an accredited nursing program.
• Registered Nurse or Licensed Vocational Nurse licensed in California.
• Current basic life support (BLS) certification.
• Minimum 3 years of clinical experience in a Skilled Nursing Facility setting.
• 1 – 2 years Case Management experience. Managed care experience preferred.
• High levels of experience or expertise in crisis intervention, teaching/coaching, disease management, and discharge planning.

Nice To Haves

• Bilingual language skills.

Responsibilities

• Facilitates transition of members from Acute setting to Skilled Nursing Facilities, Sub-Acute Facilities, Congregate Livings and Recuperative Care Centers.
• Communicate with After Hours Inpatient team.
• Clinical review of SNF placement requests and clinical progress notes.
• Receives, triages, and responds to telephone calls from facilities requiring medical and nursing inquiries.
• Performs comprehensive review of clinical records, history & physical, evaluation of Skilled need and advice while meeting production standards.
• Assesses patient problems utilizing approved MCG guidelines, directing access to care to include Skilled Nursing Facilities, Sub-acute Facilities, Congregate Livings and Recuperative Care Centers.
• Follows established clinical protocols/guidelines.
• Directs patient to appropriate levels of care based on assessment within the established guidelines.
• Communicates to After Hours Management and escalate issues as necessary.
• Facilitates authorizations for vendors and/or outside services as appropriate.
• Obtain LOA for non-contracted facilities as needed.
• Documents all calls according to established standards in REA/LEA.
• Documents all SNF inquiries and member disposition in the SNF Placement Team log daily.
• Participates in quality monitoring process by daily verbal endorsement between SNF Placement Team business hours and After Hours Team.
• Translates oral information into concise and accurate written documentation using standard medical guidelines and abbreviations.
• Shift summary to be sent to the Director, Manager and Lead of SNF Department.
• Recognizes financial, medical and legal risks based on data collected during customer interactions and follows appropriate procedures.
• Demonstrates customer service-oriented behavior at all times.
• Acts as a mentor as requested by supervisor.
• Expedites emergency calls as needed.
• Participates in regular staff meetings as scheduled.
• Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
• Performs additional duties as assigned.
• Adheres to Code of Conduct.

Benefits

• Employer-paid comprehensive medical, pharmacy, and dental for employees.
• Vision insurance.
• Zero co-payments for employed physician office visits.
• Flexible Spending Account (FSA).
• Employer-Paid Life Insurance.
• Employee Assistance Program (EAP).
• Behavioral Health Services.
• 401k Retirement Savings Plan.
• Income Protection Insurance.
• Vacation Time.
• Company celebrations.
• Employee Referral Bonus.
• Tuition Reimbursement.
• License Renewal CEU Cost Reimbursement Program.
• Business-casual working environment.
• Sick days.
• Paid holidays.
• Mileage.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees