Case Manager II

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks
Shift: Varied
Pay Rate Type: Hourly
Location: Yuma Regional Medical Ctr

Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates.
Min = $43.93
Mid = $57.10
Max = $70.28

Summary:

The Case Manager II supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. This role integrates and coordinates utilization management, care facilitation, and discharge planning functions. 

Responsibilities:

Coordinates/Facilitates patient care progression throughout the continuum; Works collaboratively and maintains active communication with physicians, nursing, and other members of the multi-disciplinary care team to effect timely, appropriate patient management; Ensures appropriate clinical pathway assignments by staff nurses; Address and resolves system problems impeding diagnostics, treatment progress, and obstacles to discharge; Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge; Utilizes advance conflict resolution skills as necessary to ensure timely resolution of issues; Collaborates with the physician and all members of the multi-disciplinary team to facilitate care for designated caseload, monitors the patient’s progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective; facilitates the following on timely basis: Completion and reporting of diagnostic testing, discharge plan, modification of place of care, communication to third-party payers, assignment of appropriate levels of care , and documentation in TQ screens and patient records.

Collaborates with medical, nursing and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting

Completes utilization management and quality screening for assigned patients; Applies approved utilization acuity criteria to monitor appropriateness of admissions and continue stays and documents findings based on department standards; Identifies at-risk populations using approved screening tool and follows established reporting procedures; Monitors length of stay (LOS) and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas; Refers cases and issues to physician advisor in compliance with department procedures and follow ups as indicated.

Ensures that all elements critical to the plan of care and clinical path have been communicated to the patient/family and members of the health care team and are documented as necessary to ensure continuity of care.

Manages all aspects of discharge planning for assigned patients; Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with the physician; Collaborates and communicates with external case managers and multidisciplinary team in all phases of discharge planning process, including initial patient assessment within 48 hours, planning, implementation, interdisciplinary collaboration, teaching, and ongoing evaluation; Ensures/maintains plan consensus from patient/family, physician and payer; Refers appropriate cases for social work intervention based on department criteria; Initiates and facilitates referrals through the resource center for home health care, hospice, and medical equipment and supplies; Documents relevant discharge planning information in the medical record according to department standards; Facilitates transfers to other facilities.

Participates actively in clinical performance improvement activities and assists in the collection and reporting of financial indicators including case mix, LOS, cost per case, excess days, resource utilization, re-admission rates, denials, and appeals.

Uses data to drive decision and plan/implement performance improvement strategies related to case management for assigned patients, including fiscal, clinical, and patient satisfaction data.

Other duties as assigned

Credentials:
Essential:
* BASIC LIFE SUPPORT (BLS)
* REGISTERED NURSE (RN)

Education:
Essential:
* ASSOCIATE'S DEGREE

Other information:

Minimum Education Required:

Associates Degree

AZ RN license

BLS (AHA)

REQUIRED: 3+ years related experience

Preferred:

BSN

Commission for Case Manager Certification (CCME)

5+ years related experience

Why Yuma Regional Medical Center?

Yuma Regional Medical Center (YRMC) is located in Yuma, AZ. Our purpose is building a healthier tomorrow. We strive by putting patients first as they are the center of every decision and action we take. YRMC is rooted in the community by living and breathing the dynamic nature of our region. Being committed to progress by constantly and consistently advancing healthcare, creating meaningful experiences and improving the lives of everyone around us.

Our Values

Bring Kindness | Achieve Together | Aspire For Better | Do The Right Thing | Lead With Optimism |

About Yuma, AZ

Named by the Guinness World Records as the Sunniest City on Earth with winters averaging temperatures of 70 degrees, sunny days and cooler nights.

Yuma, Arizona is a place to explore the great outdoors with hiking, jet skiing, boating and off-roading. Don’t forget to soak up the sun at the great Colorado River or one of Yuma’s many lakes.

Yuma is centrally located in Southwest Arizona, within a short drive to many popular attractions and destinations.

https://www.visityuma.com/

https://www.yumachamber.org/

Bring your skills to one of the sunniest places on earth - Yuma, AZ!

Physical Requirements and working conditions for this position will be provided to you up on interview.