Full time | Care Navigators On Demand | United States
Posted On 02/10/2017 Job Information Industry
Job Description Qualifications for Case Manager :
The Case Manager is responsible for managing a continuum of care
from admission through discharge for assigned patients.
Partners with medical staff, utilizes scientific evidence for
best practices, relevant data and compliance with the
mission/philosophy, standards, goals and core values.
Participates in the development of patient focused long/short
term goals, implementing, evaluating and modifying the care
Collects and reports utilization data and quality information,
such as delays in service, possible avoidable days, provider
preventable conditions, readmissions, and length of stays, etc.
Assists in preparing UM/QI case issues, gathering requested
Consults with the nursing staff working directly with clients in
the nursing care areas.
Maintains current knowledge of evidence based nursing care
Educates nursing staff about state and federal rules and
regulations in preparation for accreditation.
Evaluates and verifies employee performance through the review
of completed work assignments and work techniques.
Ensures delivery of quality care to patients, enhancement of
business development, and continuous improvement of agency
efficiency and fiscal success.
Provides instruction to hospitalized members and their families;
and serves as liaison between the member, the physician, the
hospital and the Plan.
Case Manager completes appropriate, accurate and timely,
documentation into EMR system every shift
Requirements for Case Manager :
Active CA Registered Nurse
Acute clinical experience
Experienced in case management, UR/UM
Possesses knowledge of applicable regulatory standards and is
able to perform audits based upon these standards
Solid experience dealing with UR concepts
Excellent verbal and written communication skills
Care Navigators On Demand is an Equal Opportunity Employer and
does not discriminate on the basis of race or ethnicity, religion,
sex, national origin, age, veteran disability or genetic
information or any other reason prohibited by law in