Regal Medical Group

Role Description We are hiring SNF Placement Team Case Managers, RNs/LVNs to join our team! Full time SNF Placement Team Case Manager is bonus eligible - $7,000 for LVN /$10,000 for RN, payable per company policy. The SNF Placement Team (SPT) Case Manager performs triage functions by providing support and guidance to the After Hours team by assisting with transferring patients from Acute settings to SNF, Sub-acute, Congregate Livings, and/or Recuperative Care Centers. The Afterhours SPT Case Manager responds to and coordinates service requests for transfers, requests for SNF/Sub-acute/Recuperative Care admissions, and facilitates discharges to lower levels of care to prevent additional bed days in Acute and delays in transfers. - Demonstrates self-direction in establishing priorities and working with routine supervision. - Works collaboratively with After Hours SPT Coordinator and After Hours Team after business hours and weekends. - Maintains high level of precision in judgment, accuracy of assessment, and skill in problem solving under stress. - Relates and communicates well over the telephone to all callers. Essential Duties and Responsibilities include the following: - Facilitates transition of members from Acute setting to Skilled Nursing Facilities, Sub-Acute Facilities, Congregate Livings, and Recuperative Care Centers. - Communicates with After Hours Inpatient team. - Conducts clinical review of SNF placement requests and clinical progress notes. - Receives, triages, and responds to telephone calls from facilities requiring medical and nursing inquiries. - Performs comprehensive review of clinical records, history & physical, evaluation of Skilled need and advice while meeting production standards. - Assesses patient problems utilizing approved MCG guidelines, directing access to care to include Skilled Nursing Facilities, Sub-acute Facilities, Congregate Livings, and Recuperative Care Centers. - Follows established clinical protocols/guidelines. - Directs patient to appropriate levels of care based on assessment within the established guidelines. - Communicates to After Hours Management and escalates issues as necessary. - Facilitates authorizations for vendors and/or outside services as appropriate. - Obtains LOA for non-contracted facilities as needed. - Documents all calls according to established standards in REA/LEA. - Documents all SNF inquiries and member disposition in the SNF Placement Team log daily. - Participates in quality monitoring process by daily verbal endorsement between SNF Placement Team business hours and After Hours Team. - Translates oral information into concise and accurate written documentation using standard medical guidelines and abbreviations. - Sends shift summary to the Director, Manager, and Lead of SNF Department. - Recognizes financial, medical, and legal risks based on data collected during customer interactions and follows appropriate procedures. - Demonstrates customer service-oriented behavior at all times. - Acts as a mentor as requested by supervisor. - Expedites emergency calls as needed. - Participates in regular staff meetings as scheduled. - Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. - Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality, care, and concern with each and every internal and external customer. - Performs additional duties as assigned. - Adheres to Code of Conduct. Qualifications - Graduate of an accredited nursing program. - Active Registered Nurse or Licensed Vocational Nurse licensed in California and in good standing. - Current basic life support (BLS) certification. - Minimum 3 years of clinical experience in a Skilled Nursing Facility setting. - 1 – 2 years Case Management experience. Managed care experience preferred. - High levels of experience or expertise in: - Crisis intervention - Teaching/coaching - Disease management - Discharge Planning Requirements - Good judgment and critical-thinking skills. - Compassionate and caring manner with patients. - Telephone “charisma” and forms instant rapport. - Customer service-oriented, helpful, warm, open, and inviting. - Excellent communication skills (written, verbal, and technical). - Articulate and able to communicate well at fifth- to eighth-grade level. - Bilingual language skills a plus. Benefits The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life. Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options. - Health and Wellness: - Employer-paid comprehensive medical, pharmacy, and dental for employees. - Vision insurance. - Zero co-payments for employed physician office visits. - Flexible Spending Account (FSA). - Employer-Paid Life Insurance. - Employee Assistance Program (EAP). - Behavioral Health Services. - Savings and Retirement: - 401k Retirement Savings Plan. - Income Protection Insurance. - Other Benefits: - Vacation Time. - Company celebrations. - Employee Referral Bonus. - Tuition Reimbursement. - License Renewal CEU Cost Reimbursement Program. - Business-casual working environment. - Sick days. - Paid holidays. - Mileage.