Case Manager

About the role

General Purpose

90,000 to 110,000 Salaried

Utilize critical thinking skills and care coordination expertise to work collaboratively with residents, resident family/significant other, healthcare providers, insurers, community resources, and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.

Essential Duties

• Communicate regularly with residents and their families about Plans of Care, PT, OT, and other treatment protocols.
• Attend and participate in morning meetings/stand-ups to facilitate communication with the team.
• Answer residents' questions about their care, treatment plans, illness progression, and other issues to ensure they feel safe and secure in our care.
• Monitor and adjust residents' statuses based on changing needs and conditions.
• Organize and prioritize daily work by assessing new, current, and discharging residents' needs in areas of responsibility.
• Complete documentation as required.
• Perform utilization review activities to provide residents with appropriate, timely, and cost-effective care.
• Coordinate care with residents, care providers, facility financial services, and third-party payers.
• Oversee all admissions and discharge activities.
• Coordinate referrals both to and from the facility.
• Relate positively, effectively, and appropriately with residents, families, staff, and professional colleagues.
• Ensure accurate charting and timely completion of necessary paperwork.
• Work independently and exercise sound judgment in interactions with physicians, providers, payers, residents, and families.
• Communicate effectively and promote cooperation and collaboration among residents/families/caretakers, physicians, nurses, and other ancillary partners.
• Demonstrate excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
• Utilize intermediate computer skills.
• Maintain professional, respectful, and honest interactions with residents, families, staff, and partners.

Supervisory Requirements

This position has no supervisory responsibilities.

Qualification

Education and/or Experience

• Bachelor's Degree in Social Work, Human Services, Nursing, or related field preferred (non-licensed candidates accepted).
• Prior experience in healthcare, case management, or social services strongly preferred.
• Knowledge of Medicare, Medi-Cal, and Medicaid programs and benefits.
• Familiarity with PCC (PointClickCare) or other electronic medical record systems preferred.
• Certificate as a Certified Case Manager (CCM) a plus.
• Strong communication skills with the ability to read and comprehend policy and procedure manuals, and effectively present information to residents, families, and staff.
• Demonstrated ability to organize, prioritize, and manage multiple tasks in a fast-paced environment.
• Compassionate, professional demeanor with commitment to resident-centered care.

Language Skills

• Ability to read technical procedures.
• Ability to read and comprehend policy and procedure manuals.
• Ability to effectively present information and respond to questions from managers and employees.

Mathematical Skills

Ability to apply concepts such as fractions, percentages, ratios and proportions to practical situations.

Reasoning Ability

Ability to solve practical problems. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Physical Demands

• Primarily sedentary with frequent sitting, computer use, and documentation.
• Regular walking throughout the facility to meet with residents, families, and staff.
• Occasional standing during meetings and care conferences.
• Ability to lift and carry up to 20 pounds (files, binders, supplies).
• Clear verbal communication and vision required for chart review and resident interaction.

Work Environment

The noise level in the work environment is usually low to moderate.