Bachelor's Degree in Nursing or related field preferred.
5+ years of Case Management experience in an Acute Care Hospital.
Ability to communicate effectively both verbally and in writing.
Must be able to work in a union environment.
3 years of progressive management experience preferred.
Case Management certification preferred.
Responsibilities
Supervise Case Management, Utilization Review, and Discharge planning activities.
Facilitate processes for identifying appropriate alternative placements for patients.
Streamline healthcare delivery to focus on optimal patient treatment.
Oversee case management processes to identify barriers in patient care.
Act as primary liaison for internal DRG review and third-party payers.
Ensure timely discharge of patients and manage escalation processes.
Monitor staff productivity and quality of performance.
Benefits
Full-time exempt status with varied shifts.
Opportunity for professional development and education.
Engagement in a collaborative, patient-centered care environment.
Participation in performance improvement programs.
Support for obtaining relevant certifications.
Full Job Description
JOB SUMMARY
MAJOR RESPONSIBILITIES/ESSENTIAL FUNCTIONS
Position Summary:
To lead the company to consistently deliver patient centered care that results in the best patient experience in the nation and number one in the nation in safety and satisfaction through the utilization of a collaborative approach to affect a multi-disciplinary tactic to patient care while promoting quality, cost effective outcomes.
Duties:
Supervises Case Management, Utilization Review and Discharge planning activities.
Facilitates processes associated with identifying appropriate alternative placements for patients.
Facilitates the streamlining of the health care delivery process to focus on the best treatment for the patient, thus minimizing or eliminating unnecessary steps and promoting the timely provision of care and utilization of resources.
Oversees case management process as it relates to the patient's current treatment plan in order to identify barriers to moving the patient through the continuum of care.
Acts as primary liaison for coordinating internal DRG review, contracted third party payers, contracts hospice with the assistance of social work and managed care utilization issues.
Oversee Throughput activities and ensure timely discharge of patients and/or proper escalation processes.
Attend Meetings as necessary and respond to emails timely.
Monitor productivity and quality of performance for staff report
Perform annual evaluations and provide face to face feedback to the team.
Interact in Polite and Professional Manner with all Customers.
Work on Strategy and Compliance with Vendors and other outside Partners to prevent conflicts of interest and adequate support for things such as recoup care, hospice, placement, home health, snf, etc.
Work closely with hospitalist group and physician to ensure the length of stay and other quality metrics are met and escalate as necessary.
Demonstrates knowledge and commitment to the organization hospital-wide Performance Improvement Program in order to ensure continuous quality improvement of all processes.
Oversees the programs that provide education and consultation to members of the Medical Center health care team to ensure attention to bio psychosocial needs of the patients.
Helps lead the company's effort to earn and retain JC certification and other relevant government programs.
Be present where needed, ready to work and on time for all work hours, and to recognize when situations require more effort and effective leadership to satisfy the responsibilities of the position in a timely manner
JOB QUALIFICATIONS
Minimum Education
Graduate of an accredited RN Nursing Program.
Preferred Education
Bachelor's Degree in Nursing or related field preferred.
Minimum Work Experience and Qualifications
Ability to communicate effectively verbally and in writing.
Must be able to work in a union environment.
Case Management experience in Acute Care Hospital 5 years or more required.
Preferred Work Experience and Qualifications
Three years progressive management experience in the field of expertise.
Case Management certification
Required Licensure, Certification, Registration or Designation
California Registered Nurse (RN) License.
Basic Life Support (BLS) from the American Heart Association (AHA).
Los Angeles County Fire & Safety Card (required within 30 days of hire).
Assault Response Competency (ARC) (required within 30 days of hire).
