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Title

Case Manager- Full Time  

EOE Statement It is our policy to provide equal employment opportunities and will not unlawfully consider any factors of race, religion, age, creed, national origin, gender, disability, veteran or military status, genetic information, or any and all other unlawful biases regarding federal, state or local laws with regard to workers or applicants.  
Description

Join our team and be apart of our mission "At the service of the family for life"???????

Santa Teresita further defines this mission to include the following goals:

  • Providing a continuum of short and long-term care for the elderly in a compassionate manner.
  • Upholding and promoting the dignity of life at all stages in the care we provide and to the families we serve through quality assurance and education.
  • Responsible stewardship of healthcare assets in order to provide quality of care.

 

Purpose of Your Job Position:

Coordinate with the interdisciplinary team (including but not limited to attending physician(s), social services, nurses, dietary personnel and activity personnel), resident/family and insurance providers on complex aspects of the residents' care.  Serves as the focal communication point for residents and staff in regard to the transition of the resident throughout the continuum at the appropriate level of care and authorization of services from third party payors.  Is a clinician who in conjunction with the interdisciplinary team is accountable for assessing the complex plan of care, effective and efficient utilization of resources, meeting established professional and regulatory standards, and who collaborates with the healthcare team and the resident/family to accomplish agreeable outcomes.

 

 

Job Functions:

Every effort has been made to identify the essential functions of this position.  However, it in no way states or implies that these are the only duties you will be required to perform.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position, or in keeping with the individual’s skills and qualifications.

Duties and Responsibilities:

Assist DON  and ADON in developing methods for coordination of nursing services with other resident services to ensure the continuity of the residents’ care

Assists with the development, revision, and coordination of the Interdisciplinary Plan of Care for complex discharges through, communication with physician, social services, nurses, and other health care team members to meet the residents' needs effectively, efficiently and at the appropriate level of care required

 Works with physicians, staff from other departments, third party payors, HMO’s, families, etc. to facilitate the transition of the resident throughout the continuum at the appropriate level of care

 Coordinates complex discharge services throughout the continuum, communicating pertinent information of residents' progress and plan of care to appropriate referral sources, alternative levels of care, and community agencies

 With other team members and information from the chart, assesses the complex residents' needs, their support systems, and available community service providers, and assists with appropriate and cost-effective discharge planning

Primary communicator to third party payors for request and authorization of services determined to be necessary for appropriate care

Ensure authorizations and memorandums of understanding reflect accurately current level of care for billing purposes

Communicates significant changes of level of care and services to billing section of Finance Department

Documents actions appropriately

 Serves as a resource contact and information source to residents, families, significant others, and staff

 Provides suggestions and collaborates with the development of new programs and services, or revision of existing processes based on data analysis of length of stay variances, readmissions, scheduling and practice patterns, DRG and cost management data, and other sources

 Contributes to the formulation and updating of unit policies, procedures, and protocols, and adheres to these and other professional and regulatory standards

Through measurement and trending of resident outcomes and various data sources, identifies areas of performance improvement and opportunities

Assist in the collection, review and evaluation of data and monitoring tools.  Create written and oral reports on trends and observations to the DON

May perform other clinical nursing duties as necessary or assigned

Adheres to professional dress code that reflects the mission of Santa Teresita with excellent grooming and appearance

Be knowledgeable and follow all safety procedures and regulations established in the employee handbook and other policies

Lead, participate in and attend various departmental meetings and others as requested by DON or Administrator

Attend all inservices and other training required by this position

Working Conditions:

Subject to interruptions

Subject to hostile behavior from residents and visitors

Fast-paced environment

Ambient temperatures that are higher than 74°F to preserve comfort of residents

Exposure to chemicals, needles and bodily fluids

Provide direct and indirect nursing care as needed

Physical and Sensory Requirements:

 Must be able to see and hear or use prosthetics that will enable these senses to function adequately to assure that the requirements of this position can be fully met

Ability to lift a minimum of 25 pounds alone, and a minimum of 50 pounds in partnered lifting to a height of 5 feet

Ability to push/pull or move a minimum of 250 pounds for a distance of 1, 000 feet

Ability to reach overhead, bend, squat and crouch

Ability to stand and walk about for long periods of time

 

 
Position Requirements

Qualifications and Education Requirements:

Current licensure as a Licensed Vocational (LVN) or Registered Nurse (RN) in the State of California

Certification in Case Management  preferred

Current CPR certificate and Basic Cardiac Life Support Certificate

Minimum of two years experience as a clinical nurse required with two years of case management experience and marketing experience required

Maintain current knowledge and skill. Must show evidence of continuing education in management/leadership and care coordination seminars and workshops.

Able to read, write and speak English fluently in a manner that can be clearly understood by others

 

Skills and Job Requirements:

Knowledge in state and federal regulatory standards

Excellent written and verbal communication skills

Basic knowledge of the Quality Improvement process and skilled nursing organization

Excellent clinical knowledge and ability to perform assessments

Working knowledge of the Medi-Care, Medi-Cal, and Managed Care process.

Working knowledge of the California Coordinated Care Initiative, Dual eligibility,  and HMO contracts (authorization and billing processes)

Demonstrate high ethical standards and professional conduct

Excellent Interpersonal  and customer service skills

Treat and converse with residents, visitors and staff  in a manner that exhibits respect, professionalism and tact

Self-motivated in time management and prioritization of workload for effective outcomes

In-depth understanding of the aging process, its physical, psycho-social and spiritual consequences and the ability to apply that understanding in practical support of each individual resident

Critical thinking skills, decisive judgment

Basic computer literacy for word processing and database set-up / use

 
Full-Time/Part-Time Full-Time  
Shift Days  
Salary Range DOE  
Position Activities Assistant  
Number of Openings 1  
Exempt/Non-Exempt Non-Exempt  
Location Santa Teresita  
About the Organization The Carmelite Sisters of the Most Sacred Heart of Los Angeles celebrate 90 years of service to the Los Angeles Archdiocese through apostolic works in health care, education and spiritual retreats.

Please visit our website for more information: www.carmelitesistersocd.com/directory/  

This position is currently accepting applications.

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