Case Mgr at Links Healthcare Group in San Diego, CA

Join Jacob Healthcare Center as a Receptionist and make a meaningful impact in a supportive, five-star environment!

WHY CHOOSE JACOB HEALTHCARE CENTER?

Jacob Healthcare Center, located at 4075 54th Street, San Diego, CA, is a leading provider of patient-centered medical services with 156 beds. We focus on compassionate care, empowering patients to achieve their health goals in a supportive environment.

Our dedicated team offers a wide range of services, including primary care, specialty services, preventive care, and mental health support. We are proud to have a 5-star Customer Satisfaction Management (CSM) rating, reflecting our commitment to excellence.

At Jacob, we offer a supportive and rewarding work environment. Our five-star rating reflects our commitment to excellence, and we provide a dynamic setting where you can thrive. We prioritize training, especially for new graduates, with our hands-on staff personally guiding you. Here, you'll have the opportunity to care for high-acuity patients and receive regular updates and support from your supervisors.

Overview of the position:

The Case Manager role involves coordinating delivery of services to managed care and Medicare residents in collaboration with the facility’s team members. Responsible for facilitating interdisciplinary plans and assuring progress reports are completed and provided to payor as required; Also serves as liaison between patient, physician, care team members, payor, and the discharge planner by coordinating, monitoring, and communicating patient’s progress and cost evaluation and assisting with coordination to the next level of care. The Case Manager monitors and documents the cost effectiveness of treatment provided, facilitates and coordinates the admission and discharge process, serves as the resident and family advocate and acts as a liaison to insurance and medical management professionals.

Specific duties include, but are not limited to:

• Negotiates appropriate level of care within contract terms with the payor case manager; Utilizes “Out of Contract Pricing Worksheet” for non-contracted arrangements.

• Communicates information to the care team and coordinates the patient's smooth transition to the next level of care.

• Obtains accurate information from physicians, patient, and payor source regarding the expected discharge plan and communicates this information to the interdisciplinary team.

• Develops referrals from hospitals' social service and discharge planning departments, physicians, case managers, insurance companies and other referral sources.

• Participates in Marketing Action Plan and Key Account Meetings and assumes Key Account Management responsibilities as directed by their supervisor.

• Coordinate and provide care that is safe, timely, effective, efficient, equitable, and client-centered.

• Handle case assignments, review case progress and determine case closure.

• Help clients achieve wellness and autonomy.

• Facilitate multiple care aspects (case coordination, information sharing, etc).

• Help patients make informed decisions by acting as their advocate regarding their clinical status and treatment options.

• Develop effective working relations and cooperate with the medical team throughout the entire case management process.

• Take the extra mile and interact with patients to keep track of their progress and to ensure satisfaction.

• Record cases information, complete accurately all necessary forms.

• Help with staffing if necessary.

• Ensure that daily skilled documentation is in place for skilled patients.

• Works collaboratively with Rehab, MDS Coordinator, Business Office, Admissions, ADONs and DONs.

• Conduct PPS/Skilled Kaiser Meetings as scheduled.

• Prepares and updates MCR/ Skilled Tracking Sheet.

Knowledge/Skills/Abilities:

• Proven working experience in case management.

• Excellent knowledge of case management principles, healthcare management and reimbursement.

• Previous experience working in skilled nursing facility.

• Effective communication skills.

• Excellent organizational and time management skills.

• Problem solving skills and ability to multi-task.

• Compassionate with teamwork skills.

• Comprehensive knowledge of managed care.

• Familiarity with long- term care and/or sub-acute care is useful. Strong oral, written, and organizational communication skills required.

Qualifications:

• Proven working experience in case management.

• Must be a graduate of an accredited school of nursing; BSN degree preferred.

• Valid RN /LVN license in the state of California.

• BS degree in related healthcare field.

• 2 years of medical, clinical, concurrent review or pre-certification case management experience is preferred.

Benefits:

• Paid sick leave

• PTO

• Dental

• Vision

• 401(k)

• Healthcare insurance

• Life insurance

We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.