Mar 15, 2019
The **Case Manager** assists the organization by assuring that the right care is provided at the right place, at the right time. To accomplish these goals, the Case Manager: uses established criteria to evaluate the appropriateness of admission, level of care, and readiness for discharge; assures the timely movement of patients throughout the continuum of care by conducting concurrent reviews and resolving delays as necessary; assesses patients’ post-discharge needs and develops and implements the plan; submits clinical information to assure reimbursement; and coordinates care with the treatment team, family and others as necessary.
Current California RN Licensure required.
BSN strongly preferred
National certification in Case Management (ACM, CCM) preferred.
Previous Leadership experience preferred.
+ Minimum 3 years previous acute care experience or equivalent education commensurate with is required.
+ Previous case management experience preferred.
+ Broad acute clinical background (experience in more than one population _and_ level of care) strongly preferred.
+ InterQual experience preferred.
+ Utilize critical thinking skills and clinical knowledge to create a viable and effective patient transition plan and identify delays in service, or quality issues that impede the progression of care required.
+ Basic knowledge of governmental (Medicare, Medi-Cal, etc.) healthcare reimbursement systems is preferred.
+ Advanced knowledge of healthcare reimbursement systems: HMO, PPO, capitated agreements, PPS, etc., preferred.
+ Advanced knowledge of post-acute healthcare resources such as: SNF, Home Health, Hospice, AIM, etc., required.
+ Intermediate level computer skills required.
+ General typing skills (35 WPM) required.
+ General knowledge of coding and DRG assignment process preferred.
+ Must be able to effectively communicate with, and promote cooperation and collaboration between, multiple people including: patients and their families; physicians, nurses, social workers, etc. Ability to seek input and receive feedback in a collaborative interdisciplinary team.
+ 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.
+ Must possess leadership, delegation, and supervisory skills to guide staff and hold others accountable.
+ Must be self directed and organized with the ability to independently prioritize and follow through to achieve desired clinical, satisfaction and financial outcomes.
+ Must have strong clinical assessment skills necessary to provide utilization review and transition planning services to meet the patients’ complex medical, emotional and social needs.
**Organization:** Sutter Valley Hospital
**Employee Status:** Regular
**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:** Per Diem
**Hrs Per 2wk Pay Period:** Per diem
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.