Case Manager - Critical Need

Job Summary:

• The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population.
• The PPC collaborates with rounding client Hospital Based Service Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure continuum of patient care progressions for clinical and cost-effective outcomes.
• The PCC facilitates and coordinates with community providers and ambulatory case managers to assist with the appropriate level and transition of care for a safe discharge and preventing a re-admission.

Responsibilities:

• Completes an initial face-to-face assessment for every admitted member to identify discharge needs within 24 hours of admission.
• Document in client and communicate the assessment outcomes to determine the appropriate transition plan with client physician healthcare team and patient/family.
• Review and document discharge plan in accordance with KP discharge planning documentation policies, facility policies and regulatory requirements.
• Send referrals/communicate with in-network vendors for coordination of post-acute levels of care such as Home Health, DME, IV Infusion, SNF Sub-Acute and Acute Rehab.

Requirements:

• Associate Nursing Degree.
• 1 year in an acute medical/surgical/ ED or critical care nursing area.
• Experience using an electronic medical record system.
• Knowledge of health/care reimbursement systems (Medicare Advantage, Commercial payer, Medicaid and CMS regulatory rules)
• Completion of PCC Assessment of Critical Skills.