The Case Manager will serve as a a member of the Care Coordination group of the Center for Health Management and Education. The Case Manager will be responsible for assessing patients at risk of hospitalization or rehospitalization and decompensation. In addition, the Case Manager will assess patients' needs for support, education and coaching, and provide for those needs or referring to available resources. The Case Manager will perform data collection and evaluation of case management process and outcomes. The Case Manager serves an integral role of Care Coordination in the Patient Centered Medical Home.
--California State RN License or MSW required. --Knowledge of and experience with case or care management processes. --Extensive, broad-based clinical experience. --Experience identifying and analyzing care/service needs for case managed patients. --Skills to perform in-depth chart analysis to provide accurate information in a concise, informative manner. --Ability to develop and maintain effective telephonic relationships. --Knowledge of care/services provided at differing levels of care, i.e., ambulatory and institutional settings. --Knowledge of and experience with medical and nursing treatment plans. --Analytical skills to identify and obtain pertinent data from multiple sources. --Ability to make independent judgments based on clinical knowledge and experience. --Ability to work with all levels of staff, both inter- and intradepartmental. --Effective time management skills.
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