North East Medical Services
NURSE CASE MANAGER I P
North East Medical Services, Burlingame, California, United States, 94012
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Description Nurse Case Managers are licensed nursing professionals responsible for coordinating continuous care and discharge planning activities, developing individualized person‑centered care plans and goals, and facilitating case conferences among all service providers for a caseload of assigned patients.
Nurse Case Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and care, and participate in program development and quality improvement initiatives in their role, applying guidelines and collaborating with multidisciplinary teams. Case Managers influence and direct the delivery and quality of patient care. The objectives are to facilitate timely discharges, prompt and efficient use of resources, achievement of expected outcomes, collaborative practice, coordination of care across the continuum, and performance/quality improvement activities that lead to optimal patient outcomes.
They differ from other roles in professional nursing/health care practice in that they do not provide direct medical care to patients; rather, a Nurse Case Manager will be assigned to specific patients to ensure that medical services and treatments are accomplished in the most financially and clinically efficient manner.
Essential Job Functions
Apply professional clinical skills and expertise in assessment, planning, implementation, and coordination of necessary healthcare services.
Develop and manage individualized plans of care to assure consistent, timely, and appropriate care is provided in a patient‑focused manner; collect data, assess needs, identify problems and options, plan appropriately, set goals, monitor and evaluate progress.
Provide an interdisciplinary process in which healthcare team members collaborate with patients and families to support quality care and ensure continuity.
Provide disease management to patients with diseases such as end‑stage renal disease, cancer, and palliative care.
Manage patients in different case management programs such as Chronic Care Management, Enhanced Care Management, Community Support, and Complex Case Management programs.
Facilitate timely implementation of hospital discharge plans in collaboration with interdisciplinary team members; arrange follow‑up care as appropriate.
Perform home visits to patients meeting complex case management criteria; perform medication reconciliation within nursing scope; accompany patients to provider visits as needed.
Collaborate with MSO Utilization Management team and PCPs to ensure resource utilization is appropriate; plan and implement strategies to reduce resource consumption.
Identify community resources and assist patients in applying for needed services.
Participate in development of policies and procedures to meet program requirements; participate in internal and external meetings and present relevant information to designated committee.
Make complex clinical decisions regarding medical care; involve medical directors and providers to solve complex issues.
Utilize multiple systems to maintain documentation of case management activities; collect, analyze and report on data for utilization, quality improvement, compliance, and other areas as assigned.
Assist in training new Nurse Case Managers and Care Coordinators to guide accurate completion of work.
Perform other job duties as required by manager/supervisor.
Qualifications
Bachelor’s degree required.
Valid California Registered Nurse license.
Demonstrate willingness to make decisions within RN's clinical scope of practice; exhibit sound, accurate, and ethical judgment.
Ability to engage and work collaboratively with patients, families, clinical team members, supervisors, and community resources.
Ability to provide detailed, concise note/documentation within workflow turn‑around timelines.
Basic medical knowledge, including ability to observe safety and security procedures and recognize trauma symptoms and behaviors.
Good communication and interpersonal skills; ability to work with people from diverse backgrounds and experiences.
Able to spend 20‑40 minutes at a time with patients in the community, including at clinics, specialist offices, hospitals, community‑based organizations, or patient’s home, which may be in understaffed/remote areas.
Valid Driver License and ability to maintain preferred vehicle.
Time management and prioritization skills are vital.
Current documentation of Basic Life Support is required.
Language
Must be able to fluently speak, read and write English.
Fluent in Chinese (Cantonese and Mandarin) required.
Fluent in other languages is an asset.
Status
This is an FLSA Exempt position.
This is not an OSHA high‑risk position.
This is a Full‑Time position.
NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).
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Description Nurse Case Managers are licensed nursing professionals responsible for coordinating continuous care and discharge planning activities, developing individualized person‑centered care plans and goals, and facilitating case conferences among all service providers for a caseload of assigned patients.
Nurse Case Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and care, and participate in program development and quality improvement initiatives in their role, applying guidelines and collaborating with multidisciplinary teams. Case Managers influence and direct the delivery and quality of patient care. The objectives are to facilitate timely discharges, prompt and efficient use of resources, achievement of expected outcomes, collaborative practice, coordination of care across the continuum, and performance/quality improvement activities that lead to optimal patient outcomes.
They differ from other roles in professional nursing/health care practice in that they do not provide direct medical care to patients; rather, a Nurse Case Manager will be assigned to specific patients to ensure that medical services and treatments are accomplished in the most financially and clinically efficient manner.
Essential Job Functions
Apply professional clinical skills and expertise in assessment, planning, implementation, and coordination of necessary healthcare services.
Develop and manage individualized plans of care to assure consistent, timely, and appropriate care is provided in a patient‑focused manner; collect data, assess needs, identify problems and options, plan appropriately, set goals, monitor and evaluate progress.
Provide an interdisciplinary process in which healthcare team members collaborate with patients and families to support quality care and ensure continuity.
Provide disease management to patients with diseases such as end‑stage renal disease, cancer, and palliative care.
Manage patients in different case management programs such as Chronic Care Management, Enhanced Care Management, Community Support, and Complex Case Management programs.
Facilitate timely implementation of hospital discharge plans in collaboration with interdisciplinary team members; arrange follow‑up care as appropriate.
Perform home visits to patients meeting complex case management criteria; perform medication reconciliation within nursing scope; accompany patients to provider visits as needed.
Collaborate with MSO Utilization Management team and PCPs to ensure resource utilization is appropriate; plan and implement strategies to reduce resource consumption.
Identify community resources and assist patients in applying for needed services.
Participate in development of policies and procedures to meet program requirements; participate in internal and external meetings and present relevant information to designated committee.
Make complex clinical decisions regarding medical care; involve medical directors and providers to solve complex issues.
Utilize multiple systems to maintain documentation of case management activities; collect, analyze and report on data for utilization, quality improvement, compliance, and other areas as assigned.
Assist in training new Nurse Case Managers and Care Coordinators to guide accurate completion of work.
Perform other job duties as required by manager/supervisor.
Qualifications
Bachelor’s degree required.
Valid California Registered Nurse license.
Demonstrate willingness to make decisions within RN's clinical scope of practice; exhibit sound, accurate, and ethical judgment.
Ability to engage and work collaboratively with patients, families, clinical team members, supervisors, and community resources.
Ability to provide detailed, concise note/documentation within workflow turn‑around timelines.
Basic medical knowledge, including ability to observe safety and security procedures and recognize trauma symptoms and behaviors.
Good communication and interpersonal skills; ability to work with people from diverse backgrounds and experiences.
Able to spend 20‑40 minutes at a time with patients in the community, including at clinics, specialist offices, hospitals, community‑based organizations, or patient’s home, which may be in understaffed/remote areas.
Valid Driver License and ability to maintain preferred vehicle.
Time management and prioritization skills are vital.
Current documentation of Basic Life Support is required.
Language
Must be able to fluently speak, read and write English.
Fluent in Chinese (Cantonese and Mandarin) required.
Fluent in other languages is an asset.
Status
This is an FLSA Exempt position.
This is not an OSHA high‑risk position.
This is a Full‑Time position.
NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).
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