Aug 14, 2019
The Ambulatory RN Case Manager reports directly to the Manager or Clinical Supervisor of the Telephonic Disease Management Programs. Certification as a Diabetes Educator (CDE) or Heart Failure RN (HFRN) is highly desirable. The Disease Tele-management Program assists Sutter Clinicians with the management of diabetes, heart failure, hypertension, hyperlipidemia and asthma. This position leads the process of developing a plan of care, and monitors all aspects to ensure they are properly implemented. The Case Manager is responsible for the triage and coordination of services for patients enrolled in one or more the programs to facilitate optimal outcomes through collaboration with the client, the family, the physician and other members of the healthcare team. The Case Manager may recommend medication adjustments to the treating provider based on the clinical assessment and knowledge of the case. Communication with various departments and disciplines, telephone monitoring, patient assessment and education, development care plans, and medication management are critical to success. The Case Manager works to support the patients in a professional manner consistent with existing or new policies. Case Managers may be called upon to provide recommendations and assist in the development of program goals and objectives for the up-coming year.
BA/BS or equivalent combination of education and experience required. BSN strongly preferred. Most successfully complete the Case Management Orientation Program within ninety days from date of hire. Current California RN Licensure required. •National certification in Case Management (ACM, CCM) and Supervisory training desired.
3-5 years of direct patient care or patient education in an inpatient, outpatient, ambulatory or home health setting required.
0-2 years Supervisory training helpful preferred
3-5 years Hospital or ambulatory case management or disease management required.
3-5 years Team leadership in a clinical nursing environment required.
0-2 years Proficiency and clinical work within the areas of cardiac telemetry, treatment of arrhythmias Previous ICU experience a plus required.
3-5 years Strong familiarity with the etiology and current therapeutic modalities in the areas of cardiac, pulmonary and diabetic care
0-2 years Experience with electronic health records and computerized patient care systems – Epic experience desirable
0-2 years Previous clinical experience in than one level of care, i.e.: Intensive Care, Med-Surg, ED, Home Health, etc., strongly preferred.
0-2 years Previous case management experience is preferred.
0-2 years Experience using InterQual is strongly preferred.
0-2 years Broad acute clinical background (experience in more than one population and level of care) strongly preferred
Successfully complete the Case Management Orientation Program within ninety days from date of hire required.
• General knowledge of illnesses, current treatments and their physical and psychosocial sequelae.
• Specific knowledge in the areas of cardiac diseases, COPD, congestive heart failure, diabetes, asthma, hyperlipidemia and hypertension
• Applicable laws and regulations regarding government and commercial insurance benefits including basic knowledge of governmental (Medicare, Medi-Cal, etc.) healthcare reimbursement systems is required, as well as advanced knowledge of healthcare reimbursement systems: HMO, PPO, Capitated agreements, PPS, etc., is preferred.
• General knowledge of coding and DRG assignment process is preferred.
• Motivational Interviewing or Shared Decision Making techniques
• Available health care and community resources appropriate for populations served
• Individual and family development over the life span and the influence of cultural and spiritual values in health care
• Data collection techniques and methods of analyzing and reporting data
• Ability to use clinical knowledge to identify potential quality of care issues, delays in service, and post-acute care needs required.
• Intermediate level computer skills are required.
• General typing skills (35 WPM) required.
• Must be able to effectively communicate with, and promote cooperation between, multiple people including: patients and their families; physicians, nurses, social workers, etc.
• Able to orchestrate successful, complex discharge plans.
• Must be able to develop an organized work plan in a high-volume environment with rapidly changing priorities.
• Ability to work independently with a minimum of direction, anticipate and organize workflow, prioritize and follow through on responsibilities
• Must have strong clinical assessment and critical thinking skills necessary to provide utilization review/discharge planning services appropriate to patients with complex medical, emotional and social needs.
• Interpersonal relationship development, problem-solving, conflict resolution, presentation, time management, positive personal influence and negotiation skills
• Ability to work respectfully and creatively with clients of diverse functional abilities, social, economic, and cultural backgrounds to support both client autonomy and client safety
• Demonstrated skills in motivating, mentoring, coaching and redirecting clients in order to achieve compliance with various necessary medical, social and functional interventions
• Leadership skills to delegate provide direction/guidance to staff and hold others accountable
• Strong clinical assessment and critical thinking skills necessary to provide care-planning and medication adjustments based on algorithms appropriate to patients with complex medical, emotional and social needs
• Strong attention to detail and accuracy
• Must have the ability to work in a high-volume caseload environment and deal effectively with rapidly changing priorities
• A demonstrated ability to work constructively with a broad spectrum of health care professionals
• Assertive and creative in problem solving, system planning and management
• Advanced computer skills are required. Ability to work with databases, Microsoft Suite and EPIC
• Must have the ability to create and communicate clearly via written and oral communication using SBAR
**Organization:** Sutter Health System Office
**Employee Status:** Regular
**Position Status:** Non-Exempt
**Job Shift:** Day
**Shift Hours:** 8 Hour Shift
**Days of the Week Scheduled:** Monday-Friday
**Weekend Requirements:** None
**Schedule:** Full Time
**Hrs Per 2wk Pay Period:** 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.