Job Abstract

Salary Range: $47.77 - $65.84

Pay rates are determined based on experience and internal equity.

Position Summary:

• Reports to the CCC Administrator
• Deliver utilization management services and social service activities within the CCC.
• Assist residents with discharge planning and transfer to appropriate levels of care to meet their needs.
  

District Responsibility:

• Support the Lompoc Valley Medical Center’s mission and values
• Demonstrate Respect, Professionalism and Courtesy to all patients, visitors, other providers and coworkers, as delineated in the LVMC “Commitment to Care”.
• Constantly use C-I-CARE principles when communicating with others.
• Demonstrate commitment to the quality philosophy and values of LVMC by maintaining established policies and procedures, organizational objectives, continuous quality improvement, quality assessment and safety standards
• Participate in performance Improvement Activities
• Participate in professional Development
• Demonstrate performance consistent with Case Management/Social services mission, philosophy, and goals for the District; remaining flexible to changing ideas; demonstrating efficiency and effectiveness in work habits
• Practice within Case Management Society of America’s Standards of practice for Case Management

Position Duties/Responsibility:

• Deliver utilization management services and social service activities within CCC.
• Assist residents with discharge planning and transfer to appropriate levels of care to meet their needs within the CCC or to an appropriate out of hospital setting
• Assist with developing and maintain policies and standards focused on maximizing reimbursement while maintain superior quality of care.
• Determines appropriate level of care based on CMS requirements.
• Assists with educating and providing guidance to physicians through clinical documentation improvement activities.
• Assist with educating and providing guidance to all District staff and physicians in the area of utilization of resources, appropriate level of care, and identification and reporting of mandated reporting issues.
• Create and nurture excellent and highly credible user and affiliated relationships with particular emphasis on superior service
• Other Duties Assigned by the Administrator

Essential Functions:

• The ability to meet all functions noted on the job description
• The ability to function unsupervised
• The ability to be supervised.
• Must work well under stress or tight deadlines.
• The ability to work as a team and attend IDT meetings.
• The ability to have positive personal interactions with staff, patients/residents and visitors.
• Must work well with supervisors, co-workers, patients/residents, family members and visitors.

Position Qualifications:

• Education: Current California license as Registered Nurse or Licensed Vocational Nurse. Bachelors in nursing degree preferred.
• Experience: Two years clinical experience in Utilization Review or Case Management is preferred.
• Certification: Must have current BLS. Case management certification is preferred.
• Skills/Ability: Working knowledge of managed care requirements, discharge planning and hospital information systems required. Must demonstrate knowledge of current utilization management principles, third party payor review requirements, age-specific principles, discharge planning process, community resources, and title 22 requirements for Social Services. Excellent verbal and written communication skills are essential. Exhibits the ability to organize work assignments and follow through with accuracy. Exercises good judgment, safe practice, demonstrates initiative, tact and poise.
• LVMC reserves the right to modify the minimum requirements depending on the needs of the organization.