Feb 08, 2019
The **Case Management Specialist** acts independently under the supervision of the nurse Case Manager to coordinate to implement the integrated discharge plan developed by the Case Manager. The Case Management Specialist uses effective interpersonal skills in managing the complex interactions involved with the position including explanation and coordination of benefits, Sutter and community resources available, and payment denial notification when indicated. This position manages the complex process of efficiently and effectively coordinating movement through the continuum of care to ensure timely discharge. The Case Management Specialist promotes integration of physician's plan for discharge through effective communication between the case management team, care providers, patients, families and external vendors.
**This position is limited term, up to 52 weeks, benefited and located in Sacramento.**
A.A. Degree in Business/Health-Related field or equivalent experience in a health care setting required. Bachelor's degree preferred.
**Experience and Knowledge:**
***Must have experience in or a combination of the following:**
· One or more years direct patient care or health education in an inpatient, skilled nursing, home health or related setting. Hospital experience preferred.
· Working knowledge of medical terminology.
· General knowledge of illnesses, current treatments and their physical and psychosocial sequelae.
· Knowledge of alternate levels of care including criteria required for payment and applications processes.
· Experience coordinating benefits and reviewing alternatives with patients and families.
· Experience drafting and issuing denial letters per regulatory and HMO guidelines.
· Knowledge of applicable laws and regulations, government and insurance benefits, especially Medicare, Medi-Cal.
· Knowledge of patient transportation criteria.
· Knowledge of available health care and community resources appropriate for populations served.
· Knowledge of individual and family development over the life span and the influence of cultural and spiritual values in health care.
· Knowledge of data collection techniques and methods of analyzing and reporting data.
Excellent oral and written communication skills. Excellent interpersonal skills and time management skills, ability to work effectively in a fast pace environment, with rapidly shifting priorities and competing demands. Ability to work independently with a minimum of direction. Ability to exercise discretion and make independent judgments, seeking review when decisions represent significant departure from established guidelines. Ability to communicate in Spanish, Russian or Asian language is helpful, but not required. PC skills, word processing, spreadsheets and data base programs.
**Organization:** Sutter Valley Hospital
**Employee Status:** Limited Term
**Employee Referral Bonus:** No
**Position Status:** Non-Exempt
**Job Shift:** Day
**Shift Hours:** 8 Hour Shift
**Days of the Week Scheduled:** Varied Days
**Weekend Requirements:** Other
**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.