Job description

Case Manager Nurse

JOB FUNCTIONS: Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.
GENERAL DUTIES AND RESPONSIBILITIES:
1) Communicate resident status, change in function and care plan either by phone or written report to payers.
2) Assess / observe residents’ condition is appropriate for admission and or discharge, to insure safe placement.
3) Perform Vital Signs when required.
4) Notification of Family, Physician and Director of Nursing in the coordination of resident care and management.
5) Manage and coordinate with Nursing team the appropriate admissions and discharge of Residents served.
6) Include payer representative in interdisciplinary meetings if requested or deemed necessary to promote payer/provider relationship.
7) Document all payer interactions regarding resident progress, expected outcomes and reporting capabilities including special instructions.
8) Ensures thorough and timely communication with managed care/insurance case managers to coordinate certification and concurrent stay programs.
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Case Manager Nurse
9) Maximize benefits by coordination of cost effective care, avoid fragmented care and duplication of services and ensure the appropriate level of care is provided in the most suitable setting.
10) Meet with facility interdisciplinary team to coordinate services to ensure that the resident’s total regimen of care is maintained.
11) Participate in all Medicare and managed care resident interdisciplinary meetings.
12) Work with team members to ensure discharge planning goals and objectives are developed and discussed at the interdisciplinary team meetings.
13) Assist in planning the services required in the resident’s discharge plan as necessary.
14) Maintain communication with facility business office and medical records to ensure accurate census and payment of managed care and Medicare residents/
15) Perform random charting audits to ensure accurate and thorough documentation to support reimbursement of services rendered.
16) Meet with residents, and/or family members, as necessary. Report problem areas to department directors.
17) Assist with contract negotiations as necessary.
18) Agree not to disclose assigned user ID code and password for accessing resident/facility information and promptly report suspected or known violations of such disclosure to the Administrator.
19) Agree not to disclose resident’s protected health information and promptly report suspected or known violations of such disclosure to the Administrator.
20) Report any known or suspected unauthorized attempt to access facility’s information system.
SPECIFIC REQUIREMENTS:
1) Must possess a current, unencumbered, active license to practice as an RN or LPN/LVN in this state.
2) Must be a supportive team member, contribute to and be an example of team work and team concept.
3) Must be able to read, write, speak, and understand the English language.
4) Must possess the ability to deal with personnel, residents, family members, visitors, government agencies/personnel, and the general public.
5) Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to managed care and nursing care facilities.
6) Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.
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Case Manager Nurse
7) Must possess the ability to plan, organize, develop, implement, and interpret the programs goals, objectives, policies and procedures, etc., that are necessary for providing quality care.
8) Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents.
9) Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices.
10) Must be able to relate information concerning a resident’s condition.
11) Must not pose a direct threat to the health or safety of other individuals in the workplace.
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Case Manager Nurse
ACKNOWLEDGMENT:
I have read this job description and fully understand that the requirements set forth therein have been determined to be essential to this position. I hereby accept the position of Case Manager Nurse and agree to perform the tasks outlined in this job description in a safe manner and in accordance with the facility’s established procedures.
I understand that as a result of my employment, I may be exposed to blood, body fluids, infectious diseases, air contaminants, and hazardous chemicals, and that the facility will provide to me instructions on how to prevent and control such exposures.
I understand that my employment is at-will, and thereby understand that my employment may be terminated at-will either by the facility or myself, and that such termination can be made with or without notice.

Job Type: Full-time

Pay: $30.00 - $33.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance

Physical setting:

• Long term care

Schedule:

• Day shift
• Monday to Friday

COVID-19 considerations:
Following COVID mitigation plan, PPE, hand hygiene, following recommendations from public health.

Ability to commute/relocate:

• Long Beach, CA 90806: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Nursing: 1 year (Preferred)
• Case management: 1 year (Preferred)

License/Certification:

• RN (Preferred)

Willingness to travel:

• 25% (Preferred)

Work Location: One location

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