case manager

case manager Tustin, CA

Kaiser Permanente
Full Time Tustin, CA 128370 - 99200 USD ANNUAL Today
Job description

case

Coordinates with physicians, staff, and non-Kaiser providers/facilities regarding patient care/population based management for patients in specifically defined geriatric or other specifically defined patient populations (e.g., patients with a specific chronic disease, high risk patients) in order to plan and implement a comprehensive, mutli-disciplinary approach to manage health conditions, utilization of resources and protocols, patient self-care, implementation and evaluation of treatment plan across the care continuum (primary, secondary, tertiary and continued care). In conjunction with physicians, develops treatment plan, monitors care, makes recommendations for alternative levels of care, identifies cost-effective protocols and care paths and develops guidelines for care that may require coordination across systems of multiple providers/services.

Essential Functions:

  • Plans, develops, assesses and evaluates care provided to members.
  • In conjunction with primary care and specialist physicians, evaluates and develops baseline medical and psychosocial evaluations and individualized patient care/treatment plans.
  • Recommends alternative levels of care and ensures compliance with federal, state, and local requirements.
  • Makes assessments of physiological and or functional status utilizing protocols.
  • Initiates appropriate diagnostic testing/screening and interventions.
  • Develops individualized patient/family education plan focused on self-management; delivers patient/family education specific to a disease state.
  • Implements strategies to target/assess risk factors and achieve and ensure patient follow-up according to clinical and strategic measures/outcomes.
  • Produces population based reports on outcomes specific to defined patient populations.
  • Participates with healthcare team/providers in actualizing outcomes by planning, evaluating and implementing decisions and strategies to achieve predetermined cost, clinical, quality, utilization and service outcomes.
  • Develops and maintains case management policies and procedures.
  • Coordinates care/services with utilization and/or quality reviewers and monitors level and quality of care.
  • Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.
  • Consults with internal and external physicians, health care providers, discharge planning and outside agencies regarding continued care/treatment or hospitalization or referral to support services or placement.
  • Arranges and monitors follow-up appointments.
  • Encourages member to follow prescribed course of care (e.g., drug therapy, physical therapy).
  • Makes referrals to appropriate community services and outside providers.
  • Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.
  • Develops and collects data; trends utilization of health care resources.
  • Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.
  • Coordinates transmission of clinical and benefit treatment to patients, families and outside agencies.
  • Acts as liaison for outside agencies, non-plan facilities, and outside providers.
  • Coordinates repatriation of patients and monitors their quality of care.

Basic Qualifications:

Experience
  • N/A.
Education
  • Graduate of an academic institution accredited by the Council on Social Work Education and a Master's degree in Social Work.
License, Certification, Registration
  • N/A.

Additional Requirements:
  • Demonstrated knowledge of case management, discharge planning, transfer coordination; TJC and other federal/state/local regulations.
  • Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:

  • Minimum two (2) years of case management experience with the population to be case managed preferred.
  • Current and valid LCSW highly preferred.

PrimaryLocation : California,Tustin,Tustin Home Health
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 08:00 AM
WorkingHoursEnd : 04:30 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : NUE-SCAL-01|NUE|Non Union Employee
Job Level : Individual Contributor
Job Category : Behavioral Health, Social Services & Spiritual Care
Department : Tustin Executive Center - Long Term Care (LTC) - 0801
Travel : Yes, 50 % of the Time
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

Apply Here

About Kaiser Permanente

CEO: Gregory Adams
Revenue: $10+ billion (USD)
Size: 10000+ Employees
Type: Nonprofit Organization
Website: http://www.kaiserpermanentejobs.org
Year Founded: 1945

case manager
Kaiser Permanente

http://www.kaiserpermanentejobs.org
Oakland, CA
Gregory Adams
$10+ billion (USD)
10000+ Employees
Nonprofit Organization
Health Care Services & Hospitals
1945
Related Jobs

All Related Listed jobs

Driver
King & Fowler Liverpool, England 11 GBP HOURLY Today

Communicates with customers to update if there are issues with agreed delivery times, or changes to estimated time of arrival. Job Types: Full-time, Permanent.

Software Engineer
Naq London, England 45000 - 55000 GBP ANNUAL Today

Any Product Design experience - making cool products that users love to use. A determination to find and fix issues, pragmatic problem-solving.

integration engineer
Mosaic Partners New York, NY 145000 - 115000 USD ANNUAL Today

Top Tier Healthcare organization looking for a Integration Engineer to join their growing team. This is an excellent opportunity to be...

Residential Real Estate Mortgage Underwriter (Hybrid)
Citi London, England 50000 - 52603 GBP ANNUAL Today

Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its

Team Member (Full Time & Part Time Storewide Opportunities)
Whole Foods Market London, England 23100 - 25200 GBP ANNUAL Today

Provides excellent customer service, addresses needs of customers in a timely and effective manner and models suggestive selling techniques; answers phones and