Case Manager - Inpatient Case Management - Full-time , 8-hr. Rotating shift
Company: Stanford Health Care
Location: Stanford
Posted on: March 19, 2023
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Job Description:
If you're ready to be part of our legacy of hope and innovation,
we encourage you to take the first step and explore our current job
openings. Your best is waiting to be discovered.
Day - 10 Hour (United States of America)
Why work at Stanford Medicine Stanford Health Care (SHC)?
If you are looking for a Case Manager career that has a rotating
schedule, this could be a wonderful opportunity for you.
Whether this would be your first case management role, or you are
seasoned, here is your opportunity to work with a unique and
supportive team. You can put your bedside RN experience to great
use in case management.
Our RN Case Managers work with multidisciplinary teams.
Become part of a team that has been able to influence and direct
the continuity of patient care.
This is a Stanford Health Care job.
A Brief Overview
Case Managers are licensed nursing professionals responsible for
coordinating continuum of care and discharge planning activities
for a caseload of assigned patients. Major responsibilities include
coordinating all facets of a patient's admission/discharge;
performing utilization review activities, including review of
patient charts for timeliness of services as well as appropriate
utilization of services; and ensuring optimum use of resources,
service delivery, and compliance with external review agencies'
requirements. Case Managers act as consultants to the clinical
team, service lines, and other departments regarding patient
assessment and patient care and participate in program development
and quality improvement initiatives. In their role, Case Managers,
by applying guidelines and collaborating with multidisciplinary
teams, influence and direct the delivery and quality of patient
care. A hospital-based case management system has as its primary
goal to ensure the most appropriate use of services by patients
and, toward that end, to avoid duplication and misuse of medical
services, control costs by reducing inefficient services, and
improve the effectiveness of care delivery. Objectives are to
facilitate timely discharge; prompt, efficient use of resources;
achievement of expected outcomes; collaborative practice;
coordination of care across the continuum; and performance/quality
improvement activities that lead to optimal patient outcomes. A
Case Manager differs from other roles in professional
nursing/health care practice in that it is not intended to provide
direct patient care; rather, a Case Manager will be assigned to
specific patients to ensure that the medical services and
treatments required are accomplished in the most financially and
clinically efficient
manner.
Locations
Stanford Health Care
What you will do
Coordination of Care - Manages each patient's transition through
the system and transfers accountability to the appropriate person
upon entry into another clinical service or discharge.
Discharge Planning Coordinates and facilitates timely
implementation of discharge plans for assigned patients with
complex needs in collaboration with other interdisciplinary team
members; arranges follow up care as appropriate.
Education/Consultation - Acts as an educational resource and
provides consultation to patients and their families, hospital
medical personnel regarding the discharge planning process and
applicable regulatory requirements; educates the staff on case
management; and provides specific information related to case
types.
Lead Work - May lead the work of administrative/clinical support
staff responsible for assisting with case management for an
assigned patient caseload.
Other - Participates in department program planning, goal setting,
systems development and process improvement; participates in
department and hospital committees and task forces; develops and
maintains documentation of findings, discharge arrangements, and
actions taken according to departmental guidelines; prepares and
maintains records as required; collects, analyzes and reports on
data for utilization, quality improvement, compliance, and other
areas as assigned.
Patient Assessment / Plan of Care - Functions as a resource to and
collaborates with physicians, social workers, nurses, and other
interdisciplinary team members to assess, plan, and coordinate
patient care needs and/or performs patient assessment and develops
a plan of care to assure consistent, timely, and appropriate care
is provided in a patient-focused manner.
Quality Improvement - Participates in quality improvement
activities by identifying opportunities for improvement in such
areas as clinical outcomes, utilization of resources and concurrent
data collection; participates in clinical process improvement teams
within the department, service lines, and hospital.
Third-Party Reimbursement - Collects, analyzes reports and reviews
patient information with third-party payers to assure reimbursement
for patient services/procedures. Communicates with review
organizations / payers to provide requested clinical and
psychosocial information to assure reimbursement.
Utilization Review - Reviews prospectively, concurrently and
retrospectively all inpatients for appropriateness of admission,
level of care, and determines appropriate length of stay. Monitors
patients' length of stay and collaborates with physicians to ensure
resource utilization remains within covered
benefits and are appropriate in relationship to the patient's
clinical and psychosocial needs; plans and implements (through
multi-disciplinary meetings or rounds) strategies to reduce length
of stay, reduce resource consumption, and achieve positive patient
outcomes analyzes and addresses aggregate
variances as well as variances from individual patients and shares
this information with staff, physicians, and administration.
Education Qualifications
Bachelor's degree in nursing from an accredited college or
university
Experience Qualifications
Three (3) years of progressively responsible and directly related
work experience preferred
Required Knowledge, Skills and Abilities
Ability to collect and record data, evaluate data and statistics,
and maintain effective reporting systems
Ability to develop and perform patient assessment and plan of
care
Ability to monitor and assure the patient's access to the
appropriate level of care; the right health care providers; and the
correct setting and services to meet the patient's needs; promote
coordination and continuity in patient health care
Ability to provide age-appropriate assessments, interpretation of
data, and delivery of interventions Ability to provide appropriate
patient care and clinical information when patients are admitted,
referred, transferred, or discharged
Ability to remain knowledgeable regarding available treatments and
services
Ability to resolve conflicts and/or negotiate with others to
achieve positive results; establish and maintain effective
interpersonal relationships
Ability to understand, interpret and apply complex federal and
state hospital compliance laws, rules, regulations, and
guidelines
Ability to work effectively with individuals at all levels of the
organization
Knowledge of available patient services and treatment
Knowledge of current theories, principles, practices, standards,
emerging technologies, techniques and approaches in the nursing
profession, and the health care system, and the responsibility and
accountability for the outcome of practice
Knowledge of evaluation and assessment techniques
Knowledge of financial processes of various private and public
funding sources for health care services/procedures
Knowledge of hospital operations, organization, systems and
procedures and laws and regulations pertaining to the operation of
hospitals in California
Knowledge of medical terminology and related levels of care and
treatment
Knowledge of the full continuum of care available to patients,
interrelationships of the care components, and their effective
integration
Knowledge of the models of case management, including the
principles and practices of discharge planning, utilization review,
and quality assurance / improvement
Knowledge of the variables that affect the processes and outcomes
of patient health care
Licenses and Certifications
Nursing / RN - Registered Nurse - State Licensure and/or Compact
State Licensure required
These principles apply to ALL employees:
SHC Commitment to Providing an Exceptional Patient & Family
Experience
Stanford Health Care sets a high standard for delivering value and
an exceptional experience for our patients and families. Candidates
for employment and existing employees must adopt and execute
C-I-CARE standards for all of patients, families and towards each
other. C-I-CARE is the foundation of Stanford's patient-experience
and represents a framework for patient-centered interactions.
Simply put, we do what it takes to enable and empower patients and
families to focus on health, healing and recovery.
You will do this by executing against our three experience pillars,
from the patient and family's perspective:
Know Me: Anticipate my needs and status to deliver effective
care
Show Me the Way: Guide and prompt my actions to arrive at better
outcomes and better health
Coordinate for Me: Own the complexity of my care through
coordination
Equal Opportunity Employer Stanford Health Care (SHC) strongly
values diversity and is committed to equal opportunity and
non-discrimination in all of its policies and practices, including
the area of employment. Accordingly, SHC does not discriminate
against any person on the basis of race, color, sex, sexual
orientation or gender identity and/or expression, religion, age,
national or ethnic origin, political beliefs . click apply for full
job details
Keywords: Stanford Health Care, San Francisco , Case Manager - Inpatient Case Management - Full-time , 8-hr. Rotating shift , Executive , Stanford, California
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