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RN Case :Manager
Los Gatos, United States
Job Title: Case Manager (RN)
Job Summary: Coordinates and manages the complete cycle of patient care, from admission through discharge. This role serves as the primary point of contact for residents, families, and a multidisciplinary team to ensure timely, appropriate, and cost-effective care. The Case Manager advocates for residents' needs, educates families on treatment plans, and adjusts care based on changing conditions.
Essential Duties and Responsibilities:
- Develop, implement, and evaluate individualized plans of care for residents.
- Serve as a central communicator among residents, families, clinical staff, and third-party payers.
- Answer resident and family questions, ensuring they feel secure and informed about care, treatment, and progress.
- Monitor and adjust resident statuses and care plans based on changing needs and conditions.
- Oversee all admission and discharge activities, coordinating referrals to and from the facility.
- Organize and prioritize a daily caseload, managing new, current, and discharging residents.
- Complete timely and accurate documentation as required.
- Conduct utilization review activities to ensure appropriate, timely, and cost-effective care.
- Collaborate with financial services and third-party payers to coordinate care.
Qualifications:
- Validr RN license in the state of employment.
- A minimum of two (2) years of clinical nursing experience is preferred.
- Knowledge of Medicare, Medi-Cal, and Medicaid programs and benefits.
- Competence with PCC Knowledge is preferred.
- Certification as a Case Manager (CCM) is a plus.
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