Senior Care Manager
Full Time
Irvine, CA
$50.59 - $77.75 an hour
Posted Today
Job description
Salary Range: $50.5900 - $77.7500 /hour
Primary Duties and Responsibilities
The Care Manager (RN/MSW) utilizes clinical expertise, patient assessments, and insurance payer requirements to coordinate patients’ needs through the continuum of care including post-acute care and discharge plans. This role works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care. Resource utilization is considered when coordinating the patients’ needs through the continuum of care. May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support. May review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans. May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing. May provide psychodynamic intervention and crisis counseling to support patients and families. May educate patients and families on their healthcare options and connect them with resources. Documents pertinent patient issues, contacts and discharge plans on the medical records. Is a mandated reporter for elder, child, and spousal abuse. Performs other duties as assigned.
The Care Manager (RN/MSW) utilizes clinical expertise, patient assessments, and insurance payer requirements to coordinate patients’ needs through the continuum of care including post-acute care and discharge plans. This role works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care. Resource utilization is considered when coordinating the patients’ needs through the continuum of care. May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support. May review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans. May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing. May provide psychodynamic intervention and crisis counseling to support patients and families. May educate patients and families on their healthcare options and connect them with resources. Documents pertinent patient issues, contacts and discharge plans on the medical records. Is a mandated reporter for elder, child, and spousal abuse. Performs other duties as assigned.
In additional to the above, the Care Manager II (LCSW) trains and mentors new staff. If in a Magnet facility, participates in Magnet councils and act as a preceptor in the Nurse Care Manager intern program.
Education and Experience
Five years’ of clinical or Social Work experience in an acute healthcare system environment. Bilingual or multilingual preferred.
Five years’ of clinical or Social Work experience in an acute healthcare system environment. Bilingual or multilingual preferred.
Additional positions requirements depend on licensure and are as follows:
Care Manager II (RN) – Bachelor’s or Master’s degree in Nursing (BSN/MSN). One year of experience in discharge planning or utilization review required. Experience in Interqual or Millennium Guidelines required. Experience with healthcare database systems.
Care Manager II (LCSW) – Master’s degree in Social Work (MSW) required. One year of supervisory experience, preferably within an acute healthcare system environment.
License Required
Registered Nurse (RN) license - for Care Manager II (RN) position
Registered Nurse (RN) license - for Care Manager II (RN) position
Licensed Clinical Social Worker (LCSW) in good standing in the State of Califorina - for Care Manager II (LCSW)
Certifications Preferred
Utilization Review, Care Management, Clinical Nursing
Utilization Review, Care Management, Clinical Nursing
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