LVN/LPT Case Manager

Psychiatric hospital in Orange County is looking to hire a Temporary Full Time, LVN/LPT Case Manager

Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for CHCM/CSU roles, including but not limited to shift differential and other special pay practices, etc. The posted compensation for the position is a reasonable estimate that extends from the lowest to the highest pay at CHCM/CSU in good faith believes it might pay for this particular job, based on the circumstances at the time of posting.

**** After applying through ZipRecruiter, please visit our website at chcm.us to download our application. Please send your completed application and resume to our HR email. Thank you ****

STATEMENT OF PURPOSE

The Case Management Coordinator position encompasses all Utilization Management functions within the Case Management Department and is the single fixed point of responsibility for communication between fiscal intermediaries and the internal treatment plan.

QUALIFICATIONS

Maintains professional license as an RN/LVN, LPT,LCSW or MFT. Must have adequate experience in a psychiatric and/or medical/surgical hospital. Maturity, flexibility, leadership qualities, professionalism, strong clinical skills, communication skills and decision-making skills are required.

PHYSICAL DEMANDS

Frequent use of telephone and at times, for extended periods. Frequent sitting for long periods of time, walking and standing. Occasional bending and reaching. Occasional lifting up to 5 pounds. Corrected vision and hearing to a normal range. Finger dexterity. Frequent exposure to stressful situations. Frequent contact with the public such as county personnel and managed care companies. Minimal contact with the patient.

WORKING CONDITIONS

Working in office and hospital environment. Occasional exposure to heat and cold. Occasional exposure to noise, dirt, dust, smoke and fumes. Occasional exposure to blood borne pathogens. Occasional exposure to chemicals and general cleaning agents.

MAJOR TASKS, DUTIES AND RESPONSIBILITIES

(All duties listed below are essential to the job.)

*General Staff Accountabilities

 Employee’s conduct conforms to the Mission, Vision, Values, and Code of Conduct of College Hospital.

 Values individual differences and demonstrates sensitivity to the cultural needs of others.

 Respects the rights, privacy and property of others, and maintains strict confidentiality.

 Effectively protects all health information from unauthorized access per HIPAA regulations and all applicable local and state laws.

 Maintains required certification/license in a timely fashion.

 Exhibits good attendance and punctuality.

 Provides appropriate notice prior to vacation/time off and notifies supervisor a minimum of two hours prior to shift when unable to come to work.

 Observes allotted break and meal periods as prescribed by Hospital Policy and follows time card procedures by accurately writing in and out.

 Attends to personal affairs to avoid any interference with productivity.

 Adheres to the Dress Code.

 Demonstrates an understanding of their personal role in the case of fire/disaster and participates in Performance Improvement activities.

 Functions with an awareness of patient safety issues and applies basic principles of safety as identified within the facility.

 Follows the occurrence reporting policy and procedure in reporting any potential safety issues.

*Job Specific Duties

 Demonstrates ability to complete all regular tasks and special assignments in a timely manner.

 Strives to make good use of allocated time and accepts additional chart review responsibility as needed.

 Patient information is organized and presented in a manner which demonstrates good written and verbal communication skills and facilitates third party payor process. Able to utilize worksheets appropriately to promote standardization and maintains detailed and legible work sheets on all admissions and continues stay review cases. Able to utilize Dairyland accurately and consistently to communicate patient information.

 Conducts chart reviews for admission criteria, continued stay criteria, discharge criteria, allocation of resources, and administrative day protocols.

 Responsible for referring cases to the Physician Advisor per protocol.

 Reviews all Medicare Outlier (above 9 days) and Indigent cases (above 3 days)and documents rationale for extended stay appropriately.

 Able to complete Treatment Authorization requests timely and accurately. Coordinates collection of all pertinent information for the submission of TARs and/or appeals.

 Able to demonstrate knowledge of assigned cases to include current status (admin/acute), authorization status, discharge plans, potential concerns.

 Conduct chart audits for Medicare Compliance and alerts physicians appropriately.

 Maintain tracking and trending excel spreadsheets as directed. Ensures that information for the end of the month reporting is completed.

 Demonstrates knowledge of organizational, governmental, accrediting and third party regulations as applicable to Case Management. Maintain familiarity with Medi-Cal criteria, Medicare criteria, and health plan specific criteria. Maintain knowledge of the process of conservatorship and discharge planning guidelines (to include, but not limited to patient qualifications for discharge setting and the criteria for administrative time based on setting).

 All other duties as assigned.

*Communication

 Able to communicate in a positive professional manner and supports effective working relationships with Directors, peers, and external clients.

 Ability to review current processes and make recommendation for improvements in a positive, proactive manner.

 Able to take a leadership role in communicating and collaborating with practitioners across settings to formulate and execute a common care plan. Attends formal treatment planning to ensure proper utilization of resources.

 Able to identify and make appropriate interventions for key patient related issues and facilitate the flow of critical information among the clinical team members (to include, but not limited to resource allocation, appropriate setting, and length of stay).

*Customer Service

 Exhibits behavior that is courteous, compassionate, polite, friendly, and respectful towards patients, visitors, physicians, and co-workers and extends self to make patients, visitors, clinical staff, and peers feel welcome and respected.

Reports to: Director of Case Management