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Case Manager

Palomar Health Type Full time Posted 5/30/2014
Salary - n/a - Starts 9/19/2014
CA - California (All) - San Diego Referral - n/a -    
  At Palomar Health, we are the largest public health system in Southern California serving San Diego’s inland North County communities for more than 50 years.

As the largest hospital district in Southern California, we are also one of the most diverse. From our state-of-the-art Cardiac Care and Rehabilitation Facilities and a busy Trauma center to Home Healthcare, we deliver a full spectrum of health services to meet the needs of every member in our community.

As one of the largest employers in North County San Diego, we believe in fostering a positive environment and celebrating individual skills and contributions. We're like a small community with resources of a large healthcare system. We believe keeping our employees happy is the key to success. With an eye for future, we offer state-of-the-art technology and great benefits.

We invite you to join us in our Mission to Heal, Comfort, and Promote Health in the Communities We Serve!

To find out about career opportunities with Palomar Health, visit www.PalomarHealth.org/Careers.
Case Manager
Department:Behavioral Health
Current Location:Mental Health Unit (PHDC), Escondido, CA
Schedule:Part-Time II
Req Num:16610
Job Details:
Responsible for the utilization management process for all adult and geriatric psychiatric patient admissions to Behavioral Health Services, to include monitoring and assessing medical necessity for admission and continued stay. Responsible for all aspects of the appeal process, compliance with DRG Prospective Payment timelines, collecting, entering, analyzing data and submitting reports, training of clinical staff to insure compliance with UM procedures, functions as a principal team member in the multidisciplinary case management team, coordinating discharge planning and the plan of care. Coordinates a collaborative, well-shaped Behavioral Health Centralized Intake Service resulting in increased utilization and quality of Behavioral Health Services. Responsible for implementing the Quality Management process for all Behavioral Health departments. Ensures that patient care is documented accurately and appropriately and meets federal mandates, standards of practice, and established criteria. Participates in Performance Improvement and Quality Management training at Palomar Health; completes medical record reviews, protecting the confidentiality of all information in accordance with department and hospital policies. Supports Performance Improvement activities by collecting and analyzing information and data that support patient care. Evaluates outcomes of patient care as required and prepares reports for medical staff and hospital committees. Maintains working knowledge of current health care systems. Participates as a team member of the clinical interdisciplinary team to ensure appropriate care, support and resources to all internal/external customers and displays on-going commitment to quality. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws, and standards. Carries out the mission, vision, values, and quality commitment of Palomar Health.

Job Requirements

Minimum Education:As required by certification and/or licensure
Preferred Education:Bachelor's Degree in nursing
Minimum Experience:3 - 5 years related experience
Preferred Experience:5 - 7 years related experience
Required Certification:American Heart Association recognized BLS - Healthcare Provider
Preferred Certification:Not Applicable
Required License:Current CA RN License
Preferred License:Not Applicable


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