What are the responsibilities and job description for the Clinical Case Manager - Catalina Island position at RN-Staff?
The Clinical Case Manager is responsible for planning, organizing, and coordinating swing bed admissions and reviewing emergency department admissions and discharges. Responsibilities include providing administrative and clerical services, input into process improvement, coordinating with the referral specialist and managing, obtaining, and sharing medical records. The Clinical Case Manager works under general supervision of the Director of Nursing.
Essential Functions
Performs financial assessment to ascertain patients' source of payment for in-patient stay to begin review process and obtain timely payment for services rendered by hospital.
Provides information in response to queries from doctors' offices, families and outside facilities.
Provides case management, social services, utilization review, and discharge planning daily and on weekends as scheduled.
Identifies and coordinates swing admissions and verifies admission requirements are met before transfer, including necessary screens and tests within the appropriate time frames.
Reviews ED admissions / discharges and contacts ED patients to coordinate follow up visits with PCP or assist with coordinating transfers to another facility if needed.
Develops and maintains relationships with specialty offices to aid in any transfer or collaboration of care.
Participates and collaborates with interdisciplinary team and attends UR meetings.
Reviews patient charts when a request for counseling is received.
Reviews and assesses need for intervention and / or appropriate community resources.
Must be available at least two Saturdays a month depending on admissions.
Knowledge, Skills, Abilities
Bilingual in Spanish preferred
Ability to multitask
Proficiency in using computers and various software systems including Microsoft Office, Athena, EMR and Point Click Care.
Ability to work effectively in a fast-paced environment.
Identify, analyze, and resolve patient care problems to foster significant improvement in patient care.
Educate patients and families about the disease process and treatment.
Ability to connect, inform and advise all ancillary departments of any changes to the patient care plan.
Knowledge of community resources and support services.
Education / Experience
Three to five years of experience in clinical nursing.
One to two years' experience in case management or related field preferred.
Current Licensure to practice in the state of California.
Bachelor's degree in nursing highly preferred.
BLS required, ACLS preferred.
