DaVita LVN Care Manager/Patient Support Center in TORRANCE, California

LVN Care Manager/Patient Support Center

Description

DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Nevada, New Mexico, Florida, Colorado and Washington in its pursuit to deliver excellent-quality health care in a dignified and compassionate manner. As of June 30, 2016 DaVita Medical Group (formerly HealthCare Partners) provided integrated care management for approximately 760,000 patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.

We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.

If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita Medical Group may be the employer for you.

Currently seeking a Full Time LVN Care Manager for our Patient Support Center in Torrance

Overview:

Under the direction of a registered nurse, this position is responsiblefor after hours, weekends and holiday telephonic care management in conjunctionwith other PSC nursing duties as assigned for all six regions within HealthCarePartners. Will ensure the continuity of care in both the inpatient andoutpatient setting utilizing the appropriate resources within the parameters ofestablished contracts and patients’ health plan benefits. Facilitates continuumof patients’ care utilizing basic nursing knowledge, experience and HCP’sguidelines to ensure appropriate utilization of resources and patient qualityoutcomes. Reports findings to the Care Management department and PSCnurses by utilizing Patient Support Center email address in a timely manner

Essential Functions:

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  • Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.

  • Provides after-hours support to Hospitalist in the coordination of care from out of area to core facilities (non-contracted facilities to contracted facilities)

  • Implements current policies and procedures set by the Care Management department.

  • Reviews patient referrals within the specified care management policy timeframe (Type and Timeline Policy).

  • Coordinates treatment plans and discharge expectations and discusses DPA and DNR status with attending physician when applicable.

  • Prioritizes patient care needs and telephonically discusses treatment plans with patients and appropriate representatives of the HCP patient.

  • Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings.

  • Consults with physician and other team members to ensure that care plan is successfully implemented.

  • Coordinates provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care.

  • Communicates authorization or denial of services to appropriate parties which may include patient (or agent), attending/referring physician, facility administration and HCP claims as necessary.

  • Attends all PSC meetings.

  • Demonstrates a thorough understanding of the cost consequences resulting from care management decisions through utilization of appropriate reports such as Health Plan Eligibility and Benefits, Division of Financial Responsibility (DOFR), and Bed Days.

  • Provides accurate information to patients and families regarding health plan benefits, community resources, specialty referrals and other related issues.

  • Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

  • Performs additional dutiesas assigned

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Qualifications

EDUCATION:

  • 1 or 2 years of post-high school education or a degree from a two-year college.

  • Graduation from an accredited school of Nursing.

  • Current California LVN license.

  • Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross).

EXPERIENCE:

Minimum:

  • Over 1 year and up to and including 3 years of clinical experience.

  • At least 1 year of recent clinical experience.

Preferred:

  • 3 to 5 years of recent clinical nursing experience.

  • Previous care management, utilization review or discharge planning experience.

  • Managed care experience.

KNOWLEDGE, SKILLS,ABILITIES:

  • Computer literate.

  • Knowledge of current standards of patient care.

  • Thorough understanding of LVN scope of practice.

  • Manual dexterity to use/handle equipment and instruments.

  • Ability to effectively communicate and collaborate with physicians, patients, families and ancillary staff.

  • Ability to make sound, independent judgments and act professionally under pressure

Primary Location CA-TORRANCE - 90503

Req ID: 295464