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Case Manager II - Post Discharge

Send to my Email Email a friend Job ID 75821 Date posted 09/06/2016
Requisition ID: 75821
  • Facility: Sharp HealthCare
  • City: San Diego
  • Department: Integrated Care Management
  • Category: Case Manager Jobs
  • Job Status: Full-Time
  • Shift: Day Job
  • FTE: 1.0
  • Shift Start: 9 AM
  • Shift End Time: 6 PM
Location
This position is located in Kearny Mesa, San Diego County. Occasional travel between Sharp HealthCare facilities and provider offices; must provide own transportation.
 
Hours
8-hour shift; 9:00 am – 6:00 pm, no weekends
 
Required Skills and Qualifications
  • Current unencumbered California Registered Nurse licensure
  • Education as required for licensure
  • Three to five years of recent hospital experience
  • Three years’ experience in Utilization Management/Case Management in Managed Care arena, preferably in a medical group or HMO setting
  • Working knowledge of computer programs (Excel, Word, Access, etc.)
  • Broad based nursing knowledge in various settings along the health care continuum, including acute, long-term acute, sub-acute, skilled inpatient and discharge planning, primary care physician offices, chronic disease management and other nursing and health related specialties
  • Proficient knowledge and understanding of managed care, utilization management, case management and healthcare finances
  • Exceptional communication, customer service, critical thinking, problem solving and computer skills
  • Ability to work independently in research and decision making with minimal direction from higher level staff
  • Ability to read, speak and hear English clearly
 
Preferred Skills and Qualifications
  • Bachelor’s degree in health care, BSN highly preferred
  • Certified Case Manager (CCM) preferred (required to obtain certification within one year of hiring)
  • Case Management/Utilization Management experience in medical group or HMO setting
  • Experience in the management of complex and high risk patients 
  • Utilization Management, Quality Management or Case Management certification
  • Bilingual communication skills

Summary
The Case Manager II Post Discharge position provides management of patients transitioning from the inpatient care setting to the home and involves patient assessment and coordination of services in the immediate post discharge phase.  The Case Manager II addresses care coordination, facilitation of referrals to providers, vendors and community services, disease education, caregiver support and self-care counseling.  Responsibilities include evaluation and if necessary, modification of patient care plan based on post discharge assessment addressing medical/psychosocial status changes and facilitating patient/caregiver/family goals to align with the patient’s new identified problems/barriers and needs.  The Case Manager II Post Discharge role results in a decrease in avoidable readmissions and emergency department visits, as well as increased patient and provider satisfaction.
The Case Managers for the ambulatory area are under Utilization Management Department in the Health Services Management Division.  The case managers in this area serve patients who are post-acute, obtaining care through outpatient services, provider offices and other support services.  The Health Services division of SCMG coordinates the medical care of members for inpatient and outpatient and has a staff of 100 nurses, coordinators and support personnel to manage utilization review, case management and quality improvement functions.
Sharp Community Medical Group (SCMG) is one of the states largest and most successful IPA's.  San Diego’s largest group of private-practice physicians, is dedicated to providing high-quality, affordable medical care. Established in 1989 with over 150,000 members, the Sharp Community network includes more than 200 primary-care physicians and 500 specialists who practice independently in offices that are conveniently located throughout San Diego County to serve families in all communities.
Sharp Community doctors admit to all Sharp hospitals and Rady Children’s Hospital. In addition, Sharp Community patients have access to urgent care centers throughout the county.
Essential Physical Requirements may include:
  • Ability to sit for extended periods of time
  • Keyboarding
  • Mousing
  • Lift up to 10 pounds
  • Push/Pull up to 25 pounds
  • Carry up to 10 pounds
  • Additional physical requirements of position may be discussed during interview.
    Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class
    Keywords: 75821, Case Manager II, Post Discharge, SCMG, Sharp Community Medical Group, Nursing, RN Case Management, Ambulatory Case Management, Case Manager, Nurse, Nursing Jobs, CCM, San Diego
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