Summary
Job Summary:The SLH 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 servicesduring 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.
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1. 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.2. 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.3. 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.4. Guides the patient in understanding the nature of his illness; confers with patients and their families to prepare for the patients’ discharge.
Qualifications:
Additional Information
Note: Home Health experience and Utilization Review are highly preferred and must have acute care hospital case management nurse experience.
San Leandro HospitalSLH Social ServicesFull TimeDayCare ManagementFTE: 1
