Job Description

ENL Case Management

Compensation range:

$58.56 - $79.06

Your rate of pay will be based on applicable experience

Shift: Days
Days off: Variable
Hours per pay period: 80
Shift length: 8 Hours

Enloe Health is a Level II Trauma Center located in beautiful Northern California. We offer a full array of medical services, and our mission is to elevate the health of the communities we serve. As a Planetree organization, we place high value on hiring the right team to care for our patients and their families—care that is steeped in compassion, human connection, and mutual support. If you feel called to make a meaningful impact through empathetic, person-centered care, and thrive in a culture that values collaboration and purpose, we welcome you to join our team.

The Care Coordinator has responsibility for coordinating the care and services for assigned patients for an episode of illness or treatment in collaboration with the patient, family, physician, patient care team, and payors. The Care Coordinator utilizes advanced clinical skills to facilitate the provision of care which includes the assessment, planning, intervention and evaluation principles of the nursing process. The Care Coordinator promotes and evaluates the effective utilization of resources using current clinical knowledge, awareness of community services, and assuming a leadership role with the patient care team to achieve optimal clinical and resource outcomes. The Care Coordinator evaluates and analyzes quality/utilization cases, admission/discharge criteria, observation/1-day stays, readmits in 30 days, Medicare and diagnosis related criteria. Participates in outlier review on an ongoing basis. In addition, the Care Coordinator may be assigned to the Emergency Department. In collaboration with the patient/family, multidisciplinary team including physicians and payors ensure the patient’s progress along with emergency episode of care in an efficient and cost effective manner for assigned case load. Advocates for the patient and family throughout the entire episode of care. Maintains availability to the patient/family as a resource to facilitate communication among providers and to monitor services rendered. Remains involved until the patient is discharged or appropriately transferred to the acute care setting or an alternate level of care. Initiate appropriate clinical pathways based on admission diagnosis and to serve as a resource person for utilization management purposes.

EDUCATION / TRAINING / EXPERIENCE:

Minimum

• Two years of acute care clinical experience, one year of recent Case Management experience in an Acute or Post Acute setting, or a Master's in Nursing with a Case Management emphasis.

Desired

• Bachelor’s degree in nursing
• Experience in acute clinical case management and utilization review
• Working knowledge of managed care requirements and hospital information systems
• Prefer experience in area of assignment. Must be able to maintain confidentiality of patient information, be a patient advocate, be collaborative and able to delegate when appropriate. Must have initiative to assume fiscal responsibilities.

LICENSES / CERTIFICATIONS:

Minimum

• Current licensure with the California Board of Registered Nursing
• Current CPR recognition

SKILLS / KNOWLEDGE / ABILITIES:

Assessment, planning, intervention, and evaluation of patient care. Demonstrates current clinical nursing knowledge as evidenced by completion of staff nurse OCAT and passing medication administration examination. Maintains and regularly updates clinical nursing knowledge by completion of the Skills Fair on an annual basis. Understanding of third party reimbursement methodologies. Critical thinking and analytical skills. Must have excellent communication and interpersonal skills to establish a high degree of rapport and professional interaction. Must be able to maintain strict confidentiality at all times. Ability to build positive working relationships with physicians and external agencies. Ability to communicate with multiple levels of the organization (e.g., managers, physicians, clinical, and support staff). Capable of using (Microsoft Office Suite) Microsoft Word, Excel, Outlook, Midas, Chart Max, and Epic computer systems. Organizational and multi-tasking skills are essential. Must be able to fulfill the essential functions of the position.

Benefits Information

Enloe offers a comprehensive and competitive benefits package to all eligible employees, including, but not limited to:

• $0 premium medical plan to include vision insurance
• Prescription and dental group insurance
• Retirement with employer match
• Generous paid time off (PTO) plan that starts accruing immediately and can be used as it's earned
• Extended Sick Leave
• Flexible Spending Accounts for unreimbursed medical expenses and dependent care
• Employee Assistance Program
• Educational Assistance

Please visit the employee benefits page at http://www.enloe.org/benefits to get more in-depth benefits and coverage information or email recruiter@enloe.org to receive a full summary of benefits.