DaVita RN, Care Manager in TORRANCE, California

RN, Care Manager

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.

OVERVIEW OF POSITION

Responsiblefor ensuring the continuity of care in both the inpatient and outpatientsetting utilizing the appropriate resources within the parameters ofestablished contracts and patients’ health plan benefits. Facilitates continuum of patients’ care utilizingadvanced nursing knowledge, experience and skills to ensure appropriateutilization of resources and patient quality outcomes. Performs care management functions on-site ortelephonically as the need arises. Worksin conjunction with the care team and PCP as care team leader. Ensures evaluation is in alignment with sitebased goals.

ESSENTIAL FUNCTIONS:

  • Consistently exhibits behavior and communicationskills that demonstrate HealthCare Partners’ (HCP) commitment to superiorcustomer service, including quality, care and concern with each and everyinternal and external customer.

  • Prioritizes patient care needs upon initial visitand addresses emerging issues.

  • Meets with patients, patients’ family andcaregivers as needed to discuss care and treatment plan.

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

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

  • Coordinates treatment plans with the care team andtriages interventions appropriate to the skill set of the team members.

  • Uses protocols and pathways in line withestablished disease management and care management programs and approved bymedical management in order to optimize clinical outcomes.

  • Monitors and coaches patients using techniques ofmotivational interviewing and behavioral change to maximize self-management.

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

  • Works in coordination with the care team anddemonstrates accountability with patient management and outcome.

  • Discusses Durable Power of Attorney (DPoA) andadvanced directive status with PCP when applicable.

  • Maintains effective communication with thephysicians, hospitalists, extended care facilities, patients and families.

  • Provides accurate information to patients andfamilies regarding HMO benefits, community resources, referrals and otherrelated issues.

  • Participates actively in assigned Care ManagementCoordination Committee (CMCC) meetings.

  • Documents pertinent patient information and CareManagement Plan in Electronic Health Record and Care Management Systems asappropriate.

  • Coordinates care with central departments onassigned patient caseload, including out-of-area, inpatient central andtransplant.

  • Demonstrates a thorough understanding of the costconsequences resulting from Care Management decisions through utilization ofreports and systems such as Health Plan Benefits, Division of FinancialResponsibility (DOFR), utilization of metrics and CM reports.

  • Adheres to departmental policies and procedures asapproved by Office of the Medical Director (OMD) Quality Committee.

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

  • Performs additional duties as assigned.

Qualifications

EDUCATION:

  • Bachelor’s degree from a four-year college and/or aprofessional certification requiring formal education beyond a two-yearcollege.

  • Graduation from an accredited school of Nursing.

  • California RN license.

  • Bachelor’s degree in Nursing preferred.

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

EXPERIENCE:

Minimum:

  • Over 3 years and up to and including 5 years ofexperience in clinical setting demonstrating the ability to assess, documentand implement the nursing care plan.

  • Past clinical experience.

Preferred:

  • 3 to 5 years of acute nursing experience incritical care.

  • Previous care management, utilization review ordischarge planning experience.

  • HMO experience.

KNOWLEDGE, SKILLS, ABILITIES:

  • Computer literate.

  • Ability to type 25 wpm.

  • Knowledge of current standards of patient care.

  • Thorough understanding of RN scope of practice.

  • Manual dexterity to use/handle equipment andinstruments.

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

  • Ability to make sound, independent judgments andact professionally under pressure.

  • Valid California driver’s license, insurance andvehicle for work-related travel.

Primary Location CA-TORRANCE - 90504

Req ID: 301913