In Patient Case Manager ED
at Northbay Healthcare

Date Posted: 5/2/2019

Job Description

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In Patient Case Manager ED
Part Time (0.875 FTE); 10 hour shifts with rotating weekends, may work at either hospital (NBMC or VVH) as determined by need.
NorthBay Medical Center
Fairfield, CA

Job Summary:

  1. To assess, plan, implement, monitor and evaluate options and services to affect an appropriate, individualized plan for patient care in the Emergency Department (ED) and extending across the continuum of care. 
  2.  Ensure patients are transitioned to optimal level of care as quickly as possible.
  3. Make recommendations to the Interdisciplinary Care Team on continued patient needs from a utilization and case management perspective and effectively communicates and collaborates with the patient, family, physician(s), nursing, and other health care team members to coordinate post ED care.
  4. Using independent judgment and discretion, the patient must be assessed and reassessed as an ongoing process to address the patient’s broad spectrum of needs through the ED episode.
  5. Utilize clinical knowledge and competence, positive communication skills, problem solving and conflict resolution techniques, ability to effect change, strong skills in assessment, organization, and time management.
  6. Requires a focus on critical thinking skills, customer service skills, setting appropriate goals and measuring outcomes to effectively ensure optimal patient outcomes with consideration to financial and health plan resources. 
  7. Communicate appropriate information to care providers in the continuum of care, monitors/reports ED utilization trends and intervenes as appropriate to ensure patients are connected with available resources.
  8. Documents assessment and interventions in MIDAS+.
  9. Collaborates with the Patient Placement Coordinators/Administrative Coordinators in verifying medical necessity and insurance contract compatibility prior to a bed assignment for admitted patients from the ED.
  10. Uses MCG criteria to assess appropriate level of care and medical necessity for admission/observation status.
  11. Assesses patients based on age and development stage utilizing resources needed for both care and financing. 
  12. Coordinate transfers into the appropriate facility at the correct level of care ensuring that continued hospitalization is warranted, contracted, and appropriate. 
  13. Must be able to demonstrate and be accountable for the policies, procedures, quality assurance, guidelines and goals of the department and the organization. 
  14. Will provide assistance to coworkers in the inpatient setting as able and/or as directed by the Supervisor, or designee. 
  15. Works under the direction of Inpatient Case Management Supervisor or designee.

Education:

  1. Graduate of an accredited nursing school or college. BSN/MSN preferred.
  2. BSN is required by January 1, 2020 (excludes those employees grandfathered as
    outlined in March 2014 letter).

Licensure and Certifications:

  1. Current unencumbered California state RN license required.
  2. Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred.  

Experience, Knowledge, and Skills:

  1. Minimum of 3 years acute clinical nursing experience required.
  2. ED experience preferred.
  3. Minimum 2 years Case Management experience preferred.
  4. Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred.
  5. Basic knowledge of personal computer and software for word processing and good keyboard skills required.
  6. Ability to enter and retrieve data from relevant computer systems required.
  7. Must be competent in Microsoft Office programs including Outlook and Word.
  8. Experience with MCG, MIDAS+, Cerner, and Power Point preferred. 
  9. Knowledge of Medicare rules and regulations and Conditions of Participation, Joint Commission, Patient Safety, and the Department of Health organizational standards.
  10. Knowledge of acute care, home care, subacute care, long-term care, hospice interventions, rehabilitation options, other community resources and requirements, medical necessity guidelines, quality assurance process and determination of positive outcomes,current standards and trends in health care, best practices, management tools, and familiarity with related resources and literature. 
  11. Ability to demonstrate caring, collaboration, competence, and communication behaviors by communicating effectively with patients/families, physicians, health care personnel, supervisory staff, and peers. Demonstrates open and honest communication.
  12. Demonstrates the ability to be organized and efficient in prioritizing and managing assignments with minimal oversight and direction.
  13. Demonstrates the willingness to research, learn, and obtain knowledge for the performance of the position.
  14. Demonstrates a courteous, professional demeanor and team spirit and the ability to work in a collaborative, effective manner.
  15. Utilizes critical thinking, and applies sound clinical judgment and assessment skills for decision making.

 Other:

  1. Requires some walking, periods of sitting and standing.  Some stooping, bending, and twisting. Requires use of computer keyboard throughout the workday. 
  2. The NorthBay Way principles consist of Caring, Communication, Collaboration, and Competence. Ideal candidate must be able to demonstrate these  principles. 

#northbay​

Job Snapshot

  • Employee Type: Part-Time
  • Location: Fairfield, CA
  • Job Type: Management
  • Experience: Not Specified
  • Date Posted: 5/2/2019

About Us

At NorthBay Healthcare, we are committed to upholding the health, wellness, and vitality of the California community members throughout Solano County and beyond. Tracing our roots back to 1960, we are the area’s only locally-based, locally-managed non-profit healthcare organization. Our presence as a leader in innovative healthcare solutions is made possible by a talented team of professionals who enjoy making a difference as well as a living. We call it “The NorthBay Way.” The principles that lead our work include:

  • Caring– be friendly, be helpful; treat others in the way they want to be treated. Be compassionate; demonstrate genuine concern for the well-being of others. Affirm the worth and potential of others, and encourage caring behaviors.
  • Collaborationhonor promises and commitments; work in a spirit of cooperation. Establish and maintain healthy interpersonal relationships. Appreciate and use the knowledge and experience of others; fully support decisions once they are made. Be fair, be equitable, and be aware in all actions affecting others.
  • Communication be consistent; earn and maintain the trust of others. Listen first; strive to understand events as they have meaning to others. Provide frequent, direct, and truthful communications. Ensure a clear and compelling purpose for the work that needs to be done. Show appreciation, recognize results, and celebrate accomplishments.
  • Competence – take personal responsibility for uncompromising levels of service, quality, and safety. Be accountable for problems that cross your path: do whatever it takes to do the right thing. Manage resources with prudence and responsibility; encourage innovation and risk-taking in others. Engage in lifelong learning to grow more skilled, professionally and personally.

We are pleased to present a variety of impactful, rewarding career positions for individuals with a variety of professional skills, goals, and experience – including clinical nurse specialists, computer systems analysts, medical and health services managers, nurse practitioners, registered nurses, and more. Join the NorthBay Healthcare Talent Network today to stay up-to-date on our openings as they continue to become available!

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