Nurse Case Manager, Cardiovascular Care Position Available In Calhoun, Alabama

Job Description:

Job Summary:

In addition to the responsibilities listed below,this position is also responsible for providing case managementservices for cardiology patients to ensure quality of care using aninterdisciplinary approach; creating population-based reports onoutcomes specific to cardiology patients; acting as medical liaisonbetween cardiology patients, families, community resources, andmedical staff/providers; making post disposition follow-up calls toall patients who are not referred to an ambulatory case/caremanagement program with guidance; and facilitating a smoothtransfer to home or an alternate facility, and acting as a contactperson for dispositions while resolving standard and non-standardissues.

Essential Responsibilities:

• Pursues effectiverelationships with others by proactively providing resources,information, advice, and expertise with coworkers and members.

Listens to, seeks, and addresses performance feedback; providesmentoring to team members. Pursues self-development; creates plansand takes action to capitalize on strengths and develop weaknesses;influences others through technical explanations and examples.

Adapts to and learns from change, challenges, and feedback;demonstrates flexibility in approaches to work; helps others adaptto new tasks and processes. Supports and responds to the needs ofothers to support a business outcome.

• Completes work assignmentsautonomously by applying up-to-date expertise in subject area togenerate creative solutions; ensures all procedures and policiesare followed; leverages an understanding of data and resources tosupport projects or initiatives.

Collaborates cross-functionally tosolve business problems; escalates issues or risks as appropriate;communicates progress and information. Supports, identifies, andmonitors priorities, deadlines, and expectations. Identifies,speaks up, and implements ways to address improvement opportunitiesfor team.

• Drives services related to the initial case assessmentby: interviewing patients and their families to evaluate needs,goals, and current services with minimal day-to-day supervision;determining initial eligibility, benefits, and education for alladmissions independently; reviewing and entering authorization data(e.

g., authorization data regarding admitting/principle diagnoses,bed type(s), and disposition data for accuracy, after visitsummary) and identifying and documenting inaccuracies; recommendingresearch plans that identify new and/or existing options to assurethat quality, cost-efficient care is provided; and leveragingcomprehensive knowledge to assess medical necessity for hospitaladmission and required level of care to inform physician.

• Provides services related to monitoring and evaluating plan of careby: coordinating resources and services to assure continuity andquality of care, and sharing professional knowledge with teammembers doing the same; reviewing and updating authorizations,attending case management rounds with clinicians, and reviewingdiagnoses as needed; contacting patients periodically to assessprogress toward treatment milestones and care plan goalsindependently; identifying barriers to achieving goals and ensuringthat they are discussed with the patient and care team thoroughlyindependently; verifying that all services remain consistent withestablished guidelines and standards independently; anddocumenting/updating the patients case in all medical filesindependently.
• Drives services related to the case-planningprocess by: creating a client-focused case management plan withtreatment goals based on the patients and familys/caregivers needsunder limited direction; collaborating with health-care team,patient, and caregivers to assure plan of care is safe, agreeable,and appropriate with minimal guidance; and validating that the planis consistent with regulatory, accreditation, and regionalguidelines independently.
• Supports efforts to remain updated oncurrent research, policies, and procedures by: attending seminars,workshops, and approved educational programs and workshops specificto professional needs; contributing to the implementation ofsystems, processes, and methods to maintain team knowledge ofcommunity resources; monitoring operational team data and keymetrics applied to own work independently; making suggestions forchange or improvement as needed independently; and ensuringadherence to policies to meet regulatory requirements.
• Providesservices related to patient disposition by: identifying patientsready for disposition planning activities under limited guidance;developing, evaluating, coordinating, and communicating acomprehensive disposition plan in collaboration with the patient,family, physician, nurses, social services, and other healthcareproviders and agencies to meet each patients personal,psychosocial, economic, and cultural needs with guidance; andobtaining authorizations/approvals as needed for services for thepatient with minimal supervision.
• Connects patients with existingservices by: assisting patients with gaining access to care basedon their needs and integrating or referring them into existingprograms/services independently; referring patients to outsideentities, ambulatory case managers, care managers, social workers,and/or internal/external resources as appropriate with minimalguidance; and aiding in making location-specific adaptations asnecessary.
• Serves as liaison between internal and external careby: reviewing benefits/services available based on regulations orspecific coverage to patients, families, and other members of thecommunity and assisting with problem solving identified concernsunder limited supervision; providing case management to a caseloadof low
• and medium-risk patients referred to externalfacilities/agencies with minimal supervision; applying standardstrategies and concepts to propose recommendations ininterdisciplinary team meetings with internal and/or externalstakeholders; and leveraging comprehensive knowledge of thepatients case to act as a resource for physicians, health planadministrators, and contracted vendors.

Minimum Qualifications:

• Minimum three (3) years of cardiovascular care, cardiacrehabilitation, or heart failure experience.
• Bachelors degree inNursing or related field AND minimum three (3) years of experiencein nursing, case management, or a directly related field.
• Registered Nurse License (California) required at hire

AdditionalRequirements:

• Knowledge, Skills, and Abilities (KSAs):

Cardiovascular Case Management Care; Written Communication;Confidentiality; Health Care Compliance; Maintain Files andRecords; Acts with Compassion; Business Relationship Management;Company Representation; Managing Diverse Relationships;Relationship Building; Member Service; Patient Safety; QualityAssurance and Effectiveness;

Community Health PrimaryLocation :

California,San Francisco,San Francisco 2238

Geary Medical OfficesHoursPerWeek :

40

Shift :

Day Workdays :

Mon, Tue, Wed, Thu, Fri,WorkingHoursStart :

08:30

AM WorkingHoursEnd :

05:00

PM JobSchedule :

Full-time Job Type :

Standard Employee Status :

RegularEmployee Group/Union Affiliation :

NUE-NCAL-09

|NUE|

Non UnionEmployee Job Level :

Individual Contributor Job Category :

Nursing& Care Delivery Department :

San Francisco Hospital

• Pulmonology-Hypertension
• 0206

Travel :

No Kaiser Permanente is anequal opportunity employer committed to fair, respectful, andinclusive workplaces. Applicants will be considered for employmentwithout regard to race, religion, sex, age, national origin,disability, veteran status, or any other protected characteristicor status.