Case Manager - RN or Social Worker Per Diem

The Case Manager is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care. Through concurrent case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care. Discharge planning will begin at the time of (or prior to) admission and will be reassessed throughout the course of hospitalization. Quality and risk‑management issues will also be monitored and reported as appropriate. The CM may be assigned to various units throughout the hospital or the Emergency Department. Primary Responsibilities The CM will be responsible for integrating the assessment of the need for post‑hospital services and determination of an appropriate discharge plan for complex cases Educates patient/family as to options/choices within the level of care determined to be appropriate; initiates and ensures completion of all necessary paperwork Facilitates completion of orders as required prior to transfer of patient to the next level of care in a timely manner so discharge is not delayed Continuum of Care planning will emphasize education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists and case managers from contracted payors when appropriate to determine a discharge plan that will be of maximum benefit to the patient; involves staff from the next level of care in the treatment plan as early as possible to promote continuity and collaboration Reports on all relevant information to the staff assuming responsibility for the next level of care Employees are expected to comply with all regulatory requirements, including CMS and Joint Commission Standards Demonstrates a working knowledge of managed care and Medicare health plans as well as reimbursement related to post‑acute services within the continuum of care, and of all applicable federal and state regulations Consults with physician section leaders for support in cases where continued stay is not appropriate, and case managers are unable to come to resolution by working with the assigned physician Communicates with the department director LOS and financial information, as well as issues that may affect the Continuum of Care process All employees are expected to remain flexible to meet the needs of the hospital, which may include floating to other departments to assist as the patient’s needs fluctuate Reviews the patient plan of care with the multi‑disciplinary team; facilitates and participates in multi‑disciplinary team care conferences for patients with complex problems; communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation and continuum planning to ensure the patient receives the appropriate level of care at the appropriate time Coordinates patient care processes to achieve desired quality outcomes and identifies/controls inappropriate resource utilization Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes; assures patient rights by offering a choice when appropriate Professional Accountabilities Adheres to name badge/dress code compliance Effectively solves problems and actively pursues resolution Directly communicates with staff, physicians, patients and families in a professional and courteous manner Role models leadership behavior through courtesy, respect and efficiency Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity; arranges schedule to facilitate meetings with physicians for patient care rounds, team meetings and other opportunities to improve communication Required Qualifications RN or Social Worker with current, active, unrestricted RN license in Colorado OR Master of Social Work (MSW) Degree 2+ years of experience working as a clinician in an acute care setting with proficient knowledge of hospital workflows Live in the Boulder, CO regional area (this position is location based and not open to remote work) Willing/able to work Per Diem onsite at a hospital location in Boulder CO (at least 2 weekend shifts per month and holiday rotations) Preferred Qualifications Case management experience or certification Solid working knowledge of Microsoft packages Knowledge or understanding of community resources, policies, and procedures Proficient typing skills Proven solid clinical acumen with the ability to use sound judgment, deductive reasoning, and problem‑solving skills Demonstrates a high level of organization with the ability to stay focused on the detail Demonstrates collaborative skills and ability to interact with people of diverse backgrounds Proven solid written and verbal communication skills Proven self‑motivated and able to function in a fast‑paced work environment Proven ability to meet and maintain quality and productivity standards Proven ability to learn and understand various clinical software applications Proven effective problem‑solving and active pursuit of resolution Proven critical thinking and organizational skills Benefits Pay varies from $28.94 to $51.63 per hour based on full‑time employment. Includes a comprehensive benefits package, incentive and recognition programs, equity stock purchase, 401(k) contribution and additional benefits subject to eligibility requirements. The position is location‑based in Boulder, CO. Candidates must live in the regional area and be willing to work per diem onsite at the hospital (at least 2 weekend shifts per month and holiday rotations). Minimum wage laws are complied with. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment. #J-18808-Ljbffr Stryker Corporation