Case Manager (RN) Timely Discharge at Stanford Health Care

If youre 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 - 08 Hour (United States of America)Why work at Stanford Medicine Stanford Health Care (SHC)Are you a seasoned RN Case Manager Here is your opportunity to work with the Timely Discharge Department at its inception. You can put your bedside RN experience to great use in case management working in conjunction with the medical teams third-party companies and patients with the goal of best outcomes for continuity of care.This is a Stanford Health Care job.A Brief OverviewCase 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 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 ManagerLevel II: Advanced Case ManagerLevel III: Expert Case ManagerLocationsStanford Health CareWhat you will doCoordination of Care -- 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 assigned patients with complex needs in collaboration with other interdisciplinary team members; arranges followup 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 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.Education QualificationsBachelors Degree from an accredited college or university requiredMasters Degree preferredExperience QualificationsThree (3) years of progressively responsible and directly related work experienceRequired Knowledge Skills and AbilitiesAbility to collect and record data evaluate data and statistics and maintain effective reporting systemsAbility to develop and perform patient assessment and plan of careAbility 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 careAbility to provide age-appropriate assessments interpretation of data and delivery of interventionsAbility to provide appropriate patient care and clinical information when patients are admitted referred transferred or dischargedAbility to remain knowledgeable regarding available treatments and servicesAbility to resolve conflicts and/or negotiate with others to achieve positive results; establish and maintain effective interpersonal relationshipsAbility to understand interpret and apply complex federal and state hospital compliance laws rules regulations and guidelinesAbility to work effectively with individuals at all levels of the organizationKnowledge of available patient services and treatmentKnowledge 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 practiceKnowledge of evaluation and assessment techniquesKnowledge of financial processes of various private and public funding sources for health care services/proceduresKnowledge of hospital operations organization systems and procedures and laws and regulations pertaining to the operation of hospitals in CaliforniaKnowledge of medical terminology and related levels of care and treatmentKnowledge of the full continuum of care available to patients interrelationships of the care components and their effective integrationKnowledge of the models of case management including the principles and practices of discharge planning utilization review and quality assurance/improvementKnowledge of the variables that affect the processes and outcomes of patient health careLicenses and CertificationsNursingRN - Registered Nurse - State Licensure And/Or Compact State Licensure required .These principles apply to ALL employees:SHC Commitment to Providing an Exceptional Patient & Family ExperienceStanford 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 Stanfords 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 familys perspective: Know Me: Anticipate my needs and status to deliver effective careShow Me the Way: Guide and prompt my actions to arrive at better outcomes and better healthCoordinate for Me: Own the complexity of my care through coordinationEqual Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination inall ofits 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 hourThe 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.Required Experience:Manager Key Skills Project Portfolio Management,Motivational Interviewing,HIPAA,Computer Skills,Intake Experience,Lean Six Sigma,Conflict Management,Case Management,Team Management,Program Development,Social Work,Addiction Counseling Employment Type : Full-Time Experience: years Vacancy: 1 Hourly Salary Salary: 74 - 99