ED Case Manager
ED Case Manager
Posted on :
01-08-2025
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1 Vacancy
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Job Description
Overview:
TekWissen is a global workforce management provider headquartered in Ann Arbor Michigan that offers strategic talent solutions to our clients worldwide. This client is a locally based nonprofit healthcare organization. Their health system includes two hospitals a 100provider primary and specialty care medical group a cancer center; and a new medical fitness center.
Job Title: ED Case Manager
Location: Fairfield CA 94533
Duration: 4 Months
Job Type: Temporary Assignment
Work Type: Remote
JOB SUMMARY:
Duties:
Summary:
- The Emergency Department Case Manager Weekend (EDCM) is responsible for assessing planning implementing monitoring and evaluating options and services to create an individualized care plan for patients in the Emergency Department (ED) and across the continuum of care.
- The EDCM ensures timely transition of patients to the optimal level of care makes recommendations to the Interdisciplinary Care Team and coordinates postED care by effectively collaborating with patients families physicians nursing staff and other providers.
- The EDCM utilizes clinical knowledge communication problemsolving conflict resolution assessment organization and time management skills to drive optimal patient outcomes while considering financial and health plan resources.
- The EDCM monitors ED utilization trends ensures connection with appropriate resources documents in Cerner verifies medical necessity and insurance compatibility and uses MCG criteria to assess care levels.
- The EDCM coordinates facility transfers ensures hospitalizations are appropriate and contracted adheres to departmental policies and provides support to inpatient colleagues as needed.
- The EDCM reports to the Inpatient Case Management Supervisor or designee.
Responsibilities:
- Applies MCG criteria to monitor appropriateness of admissions level of care and continued stays.
- Documents findings and interventions in Cerner based on departmental standards.
- Manages patient care through the ED and client systems based on individual needs.
- Collaborates with physicians Social Services and client providers for care plan changes.
- Advocates for patients and families throughout the care episode.
- Remains available to patients/families to facilitate communication among providers.
- Develops individualized comprehensive care plans with physicians Social Services and the interdisciplinary team.
- Continuously assesses and reassesses patients updating discharge plans as needed.
- Transitions patients to the next level of care and involves appropriate outpatient resources.
- Transfers case management function using SBARQ format when needed.
- Coordinates patient transfers using health plan knowledge and MCG criteria.
- Initiates and facilitates outpatient referrals to prevent inappropriate hospital admissions.
- Applies knowledge of cultural psycho/social developmental and agespecific factors.
- Maintains knowledge of federal state and local regulations.
- Acts as a resource for physicians and staff on utilization management and care options.
- Communicates with health plans and acts as a liaison regarding insurance and discharge planning.
- Identifies highrisk patients and communicates with Readmissions Case Manager.
- Evaluates case management impact on outcomes and develops strategies for improvement.
- Utilizes problemsolving and conflict resolution to develop effective care plans.
- Initiates regulatory forms and letters to ensure compliance.
- Completes timely assessments documentation and reports.
- Interacts with the team to ensure appropriate postED/hospital plans.
- Informs patients/families about financial implications related to care plans.
- Maintains confidentiality of patient and electronic data as per regulations.
- Keeps current on organizational policies regulations and legislative changes.
- Documents utilization data and discharge planning in Cerner.
- Refers patients using highrisk screening criteria to appropriate followup services.
- Hands off information to inpatient case managers using SBARQ format.
Skills:
Required Skills & Experience:
- Basic knowledge of personal computers and word processing software.
- Good keyboard skills.
- Ability to enter and retrieve data from relevant computer systems.
- Competence in Microsoft Office programs including Outlook and Word.
- Knowledge of Medicare rules and regulations and Conditions of Participation.
- Knowledge of Joint Commission and Department of Health organizational standards.
- Knowledge of acute care home care subacute care longterm care hospice rehabilitation options and community resources.
- Understanding of medical necessity guidelines and quality assurance processes.
- Ability to determine positive outcomes and understand the trends and best practices.
- Familiarity with management tools and related the literature.
- Minimum of Three (3) years of acute clinical nursing experience.
Preferred Skills & Experience:
- Experience with MCG.
- Experience with Cerner.
- Experience with PowerPoint.
- Emergency Department experience.
- Minimum of Two (2) years of case management experience.
Education:
Required Education:
- Graduate of an accredited nursing school or college.
- Bachelor of Science in Nursing (BSN).
Preferred Education:
- Master of Science in Nursing (MSN).
- Required Certifications & Licensure:
- Current California state Registered Nurse (RN) license.
Preferred Certifications & Licensure:
- Certified Case Manager (CCM). OR
- Accredited Case Manager (ACM).
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Employment Type
Full-time
Key Skills
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