Case Manager - Transitional Care
Company: Stamford American International Hospital
Location: Stanford
Posted on: January 2, 2026
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Job Description:
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(United States of America) 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 patients
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. This job description
covers all classifications for Case Managers within the
organization. All Case Managers must meet all elements of the
Essential Functions, and Qualifications. There is a Voluntary
professional development program designed to recognize and reward
professional excellence in the role of Case Manager. Promotion is
determined based on the Case Manager Professional Development
Program. Here is a description of the various levels: Level I: Case
Manager Level II: Advanced Case Manager Level III: Expert Case
Manager Locations Stanford Health Care What you will do
Coordination of Care – Complex case manager who manages each
patients 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 assignedpatients with
complex needs in collaboration with other interdisciplinary team
members; arranges follow up care as appropriate. 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 patients 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/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 casetypes.
Lead Work May lead the work of administrative/clinical support
staff responsible for assisting with casemanagement 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. Education
Qualifications Bachelors Degree from an accredited college or
university required Masters Degree preferred Experience
Qualifications Three (3) years of progressively responsible and
directly related work experience 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 patients access to the appropriate level of
care; the right health care providers; and the correct setting and
services to meet the patients 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, marital status, medical condition, genetic
information, veteran status, or disability, or the perception of
any of the above. People of all genders, members of all racial and
ethnic groups, people with disabilities, and veterans are
encouraged to apply. Qualified applicants with criminal convictions
will be considered after an individualized assessment of the
conviction and the job requirements. Base Pay Scale: Generally
starting at $74.73 - $99.04 per hour The salary of the finalist
selected for this role will be set based on a variety of factors,
including but not limited to, internal equity, experience,
education, specialty and training. This pay scale is not a promise
of a particular wage.
Keywords: Stamford American International Hospital, San Francisco , Case Manager - Transitional Care, Healthcare , Stanford, California
