Inpatient Case Manager

Kindred Hospital Riverside is a 40-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with your physician and offer 24-hour clinical care seven days a week to support your journey to wellness. For those who need special care, we offer an eight-bed ICU and one negative pressure room. Located about 20 miles southeast of downtown Riverside in Perris, we provide easy driving access to restaurants, grocers, and shops.

Responsibilities

• Care Coordination
  • Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
  • Monitors all areas of patients’ stay for effective care coordination and efficient care facilitation.
  • Remains current on reimbursement modalities, community resources, case management, psychosocial, and legal issues affecting patients and providers.
  • Appropriately refers high-risk patients who would benefit from additional support.
  • Serves as a patient advocate and enhances collaborative relationships to support informed decision-making by patients and families.
  • Demonstrates knowledge of growth and development principles across the lifespan to provide age-appropriate care.
  • Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education, and identify post-hospital needs.
  • Collaborates with clinical staff in developing and executing the plan of care and achieving goals.
  • Coordinates with the interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others to plan care throughout the continuum.
• Discharge Planning
  • Conducts comprehensive, ongoing assessments to ensure timely and safe discharge planning.
  • Develops and executes effective discharge plans for each patient using critical thinking.
  • Coordinates and communicates efficiently with patients and families regarding discharge plans.
• Utilization Management
  • Conducts medical necessity reviews for appropriate utilization of services from admission through discharge.
  • Promotes effective and efficient utilization of clinical resources.
  • Performs timely and accurate clinical reviews, care collaboration, and coordination of continued stay authorization with payors.
• Other
  • Conducts job responsibilities in accordance with company standards, policies, procedures, and applicable laws.
  • Serves on Hospital and Division committees when requested.
  • Performs other related duties as assigned.

Requirements

• Must read, write, and speak fluent English.
• Must have good and regular attendance.
• No travel required.

Qualifications

• Education: Graduate of an accredited program required for RN. BSN preferred or MSW/BSW with licensure as required by state regulations.
• Licenses/Certifications: Healthcare professional licensure required as Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) / Licensed Social Worker (LSW) if required by state regulations. Certification in Case Management is a plus.
• Experience: Two years of experience in a healthcare setting preferred. Prior experience in case management, utilization review, or discharge planning is preferred.
• Skills/Abilities:
  • Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
  • Knowledge of Medicare benefits, insurance processes, and contracts.
  • Knowledge of accreditation standards and compliance requirements.
  • Ability to demonstrate critical thinking, prioritization, and time management skills.
  • Basic computer skills with proficiency in Microsoft Office, word-processing, and spreadsheet software.
  • Excellent interpersonal, verbal, and written communication skills to collaborate effectively with leadership, physicians, payors, and external customers.
  • Strong interpersonal skills for working with patients, families, and staff.

Pay

$49.83 - $63.20 per hour.

Benefits

• Medical, Dental, and Vision coverage.
• 401(k) retirement plan.
• Flexible Spending Account (FSA) / Health Savings Account (HSA).
• Life Insurance.
• Paid Time Off.
• Wellness programs.