Case Manager (non clinical)

About the Role

Utilize critical thinking skills and care coordination expertise to work collaboratively with residents, resident family/significant other, healthcare providers, insurers, community resources, and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.

Responsibilities

• Communicate regularly with residents and their families about Plans of Care, PT, OT, and other treatment protocols.
• Attend and participate in morning meetings/stand-ups to facilitate communication with the team.
• Answer residents’ questions about their care, treatment plans, illness progression, and other issues to ensure they feel safe and secure in our care.
• Monitor and adjust residents’ statuses based on changing needs and conditions.
• Organize and prioritize daily work by assessing new, current, and discharging residents’ needs in areas of responsibility.
• Complete documentation as required.
• Perform utilization review activities to provide residents with appropriate, timely, and cost-effective care.
• Coordinate care with residents, care providers, facility financial services, and third-party payers.
• Oversee all admissions and discharge activities.
• Coordinate referrals both to and from the facility.
• Relate positively, effectively, and appropriately with residents, families, staff, and professional colleagues.
• Ensure accurate charting and timely completion of necessary paperwork.
• Work independently and exercise sound judgment in interactions with physicians, providers, payers, residents, and families.
• Communicate effectively and promote cooperation and collaboration among residents/families/caretakers, physicians, nurses, and other ancillary partners.
• Demonstrate excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
• Utilize intermediate computer skills.
• Maintain professional, respectful, and honest interactions with residents, families, staff, and partners.

Requirements

• Bachelor’s Degree in Social Work, Human Services, Nursing, or related field preferred (non-licensed candidates accepted).
• Prior experience in healthcare, case management, or social services strongly preferred.
• Knowledge of Medicare, Medi-Cal, and Medicaid programs and benefits.
• Familiarity with PCC (PointClickCare) or other electronic medical record systems preferred.
• Certificate as a Certified Case Manager (CCM) a plus.
• Strong communication skills with the ability to read and comprehend policy and procedure manuals, and effectively present information to residents, families, and staff.
• Demonstrated ability to organize, prioritize, and manage multiple tasks in a fast-paced environment.
• Compassionate, professional demeanor with commitment to resident-centered care.

Skills

• Ability to read technical procedures and policy/procedure manuals.
• Ability to effectively present information and respond to questions from managers and employees.
• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
• Ability to solve practical problems and interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Physical Demands

• Primarily sedentary with frequent sitting, computer use, and documentation.
• Regular walking throughout the facility to meet with residents, families, and staff.
• Occasional standing during meetings and care conferences.
• Ability to lift and carry up to 20 pounds (files, binders, supplies).
• Clear verbal communication and vision required for chart review and resident interaction.

Work Environment

The noise level in the work environment is usually low to moderate.