RN Case Manager (Non-Supervisory)

About the role

The Registered Nurse Case Manager (RNCM) is responsible for delivering Care Management services to the SIHC population. This individual manages patients with chronic illness, mental health issues, or life-altering conditions to enhance access to various healthcare services.

Responsibilities

• Assess the patient’s physical, mental wellness, needs, preferences, financial status, and abilities.
• Develop individualized care plans based on assessment data.
• Accurately assess the criticality of need within 24 hours of referral and direct care coordination if needed.
• Collaborate with the multidisciplinary team to establish and implement the plan of care.
• Evaluate patient progress using nationally/local recognized guidelines and adjust the plan of care as needed.
• Communicate care plan to chain of command as appropriate.
• Seek guidance in challenging clinical situations.
• Assist patients and families with necessary financial assistance referrals and eligibility determination.
• Establish and provide ongoing communication between SIHC and patients who would benefit from referral to community social resource agencies.
• May cover RN clinical duties during critical staffing shortages.
• Communicate care plan to chain of command as appropriate.
• Seek guidance in challenging clinical situations.

Qualifications

• Must possess a current California Registered Nurse license.
• A minimum of 3 years’ experience in a similar healthcare role.
• Knowledge and understanding of HIPAA in the ambulatory care setting, with absolute ability to maintain confidentiality according to standards.
• Current CPR certification; ACLS must be obtained in the first four weeks of employment.
• Valid driver’s license required at the time of appointment and must be maintained throughout employment.
• Must be insurable under SIHC vehicle insurance policy at the time of hire and throughout employment.
• Licenses and certifications appropriate to the positions required education and profession must also be valid and maintained.
• Reputation for honesty and trustworthiness; responsible and able to exercise good judgment, accept administrative supervision, follow detail, and interact effectively and communicate with people in a professional and courteous manner.
• Cultural and community awareness and sensitivity.
• Strong team building, interpersonal, and organizational skills.
• Ability to establish and maintain effective peer relationships with coworkers within the Department, clinic-wide, and the public.
• Express ideas clearly, concisely, address audiences effectively, and exercise balanced judgment in evaluating situations and making decisions.
• Willing to be part of a team and cooperate in accomplishing department goals and objectives.
• Ability to prioritize, meet deadlines, take initiative, be proactive, and function in a rapidly changing environment.
• Ability to work with people of all social and ethnic backgrounds and to resolve conflicts, negotiate situations, and facilitate consensus.
• Normal clinic/office environment; sit or stand for long periods of time; reach, bend, climb, stoop, lift up to 25 lbs.; repetitive hand movement; use and view PC.

Physical and Personal Requirements

• Normal clinic/office environment.
• Sit or stand for long periods of time.
• Reach, bend, climb, stoop, lift up to 25 lbs.
• Repeative hand movement.
• Use and view PC.
• Reliable transportation and car insurance as required by the state.
• Travel as needed.

Compliance

This position plays a key role in creating a compliance culture at SIHC. Employees are expected to learn and comply with all SIHC policies and procedures. Participation in all compliance training is mandatory, and there is a heightened awareness of policies and regulations specific to one’s department and position. All SIHC employees are expected to report violations or suspected violations of compliance policies or regulations.

Other

• Applicants must successfully pass a pre-employment physical exam, tuberculin skin test or x-ray, and blood/urine/drug screening test.
• Health must be adequate to perform all duties of the position.
• Indian Preference: In the filling of any SIHC job vacancy, preference may be given to qualified Native American Indians, pursuant to the Indian Preference Hiring Act, 25 USC 472, unless other laws require the filling of a vacancy without regard to Indian preference (e.g. Public Law (P.L.) 94-437, “Indian Health Care Improvement Act (IHCIA).” To receive Indian preference for any SIHC position, the applicant must be enrolled, or be eligible for enrollment, as an American Indian with their Tribe, or must be certified as an American Indian from the designated Tribal Representative. Applicants claiming Indian preference must attach verification of their claim to the SIHC application, including Certification of form BIA-4432, which is available from the SIHC Human Resources Department. If verification is not or cannot be verified, the applicant will not receive Indian preference for purposes of the interview.