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Job Field: Office Jobs
Location: Palm Springs, CA
Salary: $Not stated

JOB SUMMARY:

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<tr><td valign="top" width="450"><b>Title: CASE MANAGER PER-DIEM DAYSLocation: CA-Palm SpringsOther Locations:The individual in this position has overall responsibility for overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements. This position integrates care coordination, utilization management, and discharge planning.The individual&#39;s responsibilities will include, but not be limited to the following activities: a) medical necessity screening b) care coordination c) discharge planning d) facilitating multi-disciplinary patient care conferences e) managing concurrent disputes f) making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST) g ) referring complex social issues to Social Service h ) communicating with patients and their families about the plan of care i) collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy) j) participating in weekly Complex Case Review k) arranging for post -discharge patient education l) clear, complete and concise documentation in eCCM m ) maintaining accuracy of patient demographic and insurance information n) identifying and documenting potentially avoidable days o) identifying and reporting over and under utilization o) and other duties as assigned.Attends hospital workshop led by the Director of Case Management or designee that includes the Tenet Case Management Model, InterQual, Discharge Planning, Utilization Management, and other topics specific to case management. Extended orientation with selected Case Managers may occur. Information used to perform job: patient data, healthcare staff documentation related to patient care, regulatory and payor requirementsSoftware used to perform job: eCCM: Clinical data interface, InterQual, Case Management documentation, secure faxing, Avoidable Day tracking, Patient Medical Record and HPF, Hospital specific Clinical SoftwareRequired:Current California RN licenseMinimum 5 years bedside experience or a LPN/LVN with 10 years in the relevant clinical specialty (e.g., case manager for pediatrics patients should have pediatric nursing experience)Excellent organizational skillsExcellent verbal and written communication skillsAbility to lead and coordinate activities of a diverse group of peopleDemonstrated critical thinking and problem solving skillsComputer literateCase Managers hired prior to August 2009 are grandfathered in with the same performance expectations.Preferred:B.S.N. preferred

KEY REQUIREMENTS:

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Not stated