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Alameda Health System
Alameda, CA, United States
AHD Case Manager RN + Alameda, CA + Alameda Hospital + AH Care Coordination + Full Time - Day + Care Management + Req #:39260-28832 + FTE:1 + Posted:March 27, 2024 **Summary** **Role Overview:** The AHD Case Manager (RN) is responsible for providing comprehensive case management services to clients identified with complex health conditions and soci
Job Source: Alameda Health SystemAlameda Health System
Union City, CA, United States
Summary Role Overview: The AHD Case Manager (RN) is responsible for providing comprehensive case management services to clients identified with complex health conditions and social challenges that are at risk for health status decline. The goals and focus of these service efforts are to provide timely delivery of intensive case management services
Job Source: Alameda Health SystemAmerican Regent, Inc.
San Francisco, CA, United States
Nature and scope This position is responsible for all sales activities, including supporting sponsorship/tradeshow opportunities for both companion and large animal events. The Territory Manager will be covering assigned territory of California - (Northern Los Angeles area). Candidate must reside in covered territory. Essential duties and Respons
Job Source: American Regent, Inc.Actalent
San Francisco, CA, United States
Description: he RN Case Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience The RN Case Manager works in collaboration with the Physician, Medical Social Worker and bedside RN to assure the timely movement of patients to the appropriate level of c
Job Source: ActalentSutter Health
San Francisco, CA, United States
We are so glad you are interested in joining Sutter Health! Organization: CPMC-California Pacific Med Center Van Ness Position Overview: The RN Case Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The RN Case Manager works in collaboration
Job Source: Sutter HealthKaiser Permanente
San Francisco, CA, United States
Description: Job Summary:Please be aware that this position is currently under review as part of the jurisdictional process with the California Nurses Association to determine whether such position should be assigned to the CNA bargaining unit. This review is on a position-by-position basis and includes an analysis of the actual duties performed in
Job Source: Kaiser PermanenteActalent
Stanford, CA, United States
Description: The RN Case Manager will be floating across multiple department's within the hospital supporting the case management team. Major responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness of services as well as appropr
Job Source: ActalentNational Staffing Solutions
San Francisco, CA, United States
At National Staffing Solutions, we have the privilege and honor of working with dedicated healthcare professionals that make a positive impact in aiding those needing healthcare services across the U.S. every day. It is our passion, drive and integrity that enables us to continue our focus in assisting remarkable healthcare professionals like yours
Job Source: National Staffing SolutionsSan Mateo, CA, United States
Summary
Role Overview:
The AHD Case Manager (RN) is responsible for providing comprehensive case management services to clients identified with complex health conditions and social challenges that are at risk for health status decline. The goals and focus of these service efforts are to provide timely delivery of intensive case management services during the transitional period beginning with hospitalization and culminating with integration back into the community setting to prevent further health deterioration and reduce the need for more costly services such as acute care hospitalization and to develop self-management skills that improve his or her long-term health status. Performs related duties as required.
DUTIES & ESSENTIAL JOB FUNCTIONS: The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
Understands insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients. Takes appropriate action when cases do not meet criteria - coordinates denials with the attending physician, and the UR physician advisor. Prepares case reports; documents treatment plan, progress notes and discharge summary related information as required by Medicare, MediCal, Title 22 and other mandated regulations according to Department standards. Keeps required statistics.
Reviews all the patients in his/her caseload in the following areas; admission criteria for medical necessity and appropriateness of care; continued stay criteria for medical necessity and appropriateness of care; resource Management issues; other issues including concerns involving under/over utilization, avoidable days and quality issues. Coordinate daily with interdisciplinary team in transitioning patient throughout hospital stay; provides discharge planning services, working with patient/family and receiving multi disciplinary input, so that an appropriate plan is developed enabling a patient to go home, or facilitates the relocation of the patients to another setting.
Coordinates disposition of Medi-Cal, self-pay, and out-of-plan patients, including working with physician to determine readiness for transfer, securing placement and completing TAR and other documentation; contacts with payers conducting phone reviews and initiates denial appeals as needed.
Conducts discharge planning assessments in a timely and complete manner. Assessments and interventions; considers the age and cultural or religious influences of the patient/family.
Guides the patient in understanding the nature of his illness; confers with patients and their families to prepare for the patients' discharge
Provides community resource education and coaching, focusing on individual client self-management principles. This includes preparing for provider visits and supporting the disease management principles introduced by the nursing team.
Reassesses the client's condition when changes occur and revises the care plan as appropriate. Coordinates and arranges for needed services with appropriate local resources. Serves as client advocate to secure services and financial benefits.
Encourages patients to develop realistic plans. Makes direct contact with or refers patient/family to appropriate community resources. Maintains knowledge of currently available resources in the community.
Serves as a mentor and educator to the organization's health care team assisting with care coordination, training, and quality improvement activities; provides staff education regarding Advance Directives and POLST when requested.
MINIMUM QUALIFICATIONS:
Education: Bachelor's degree in a related field. Master's Degree preferred.
Minimum Experience: One year related in acute care facility and/or utilization review training and/or healthcare experience.
Minimum Experience: Varied clinical experience or experience in case management/community health preferred.
Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.
Required Licenses/Certifications: BLS - Basic Life Support Certification - issued by AHA-American Heart Association.
Preferred Licenses/Certification: Public Health Nurse, Case Management, or Home Health.
Additional Information
A Community Hospital in Alameda County ... and so much more For generations, Alameda residents have found friendly, familiar faces and dedicated medical attention at their local hospital. Now, more and more individuals in Oakland and throughout the East Bay are turning to Alameda Hospital for quality care. We welcome all patients seeking an Alameda County Hospital or Bay Area Hospital who value a state-of-the-art medical facility, with a human touch. Alameda Hospital. We care.
Alameda Hospital
AH Care Coordination
Full Time
Day
Care Management
FTE: 1
Required Preferred Job Industries Other
Email Alert for AHD Case Manager RN jobs in San Mateo, CA, United States
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