Updated: Apr 5, 2024
Location: Los Alamitos
Job Type:
Department: Case Management-LOM
I. JOB SUMMARY
The position works under the direction of the RN Case Manager and/or Social Worker to complete referrals for post acute services for patients and assist with the tasks that do not require a clinical license or degree. Responsibilities include the following activities: arrange post-discharge services, create and follow up on electric referrals using the Tenet Case Management system, review patient choice letters with patients/families for required signatures, provide follow up Important Message to Medicare patients prior to discharge, communicate with patients, families and other members of the care team, complete tasks
II. TECHNICAL SKILLS/JOB SPECIFIC SKILLS/"ESSENTIAL FUNCTIONS*
TELEPHONE SKILLS - Demonstrates hospital telephone etiquette by answering the phones promptly, courteously and identifying department and self.
POLICIES/PROCEDURES- Is aware of and follows all hospital and department policies and procedures.
TEAM WORK- Promotes positive co-worker relationships through team work and cooperation. Understands and supports the needs of individuals in other departments and promotes conflict resolution. Shares information, work knowledge and experience with coworkers, physicians and students in a non-threatening manner. Offers assistance and promptly responds to requests.
PRODUCTIVITY-Maintains high productivity and performs efficiently regardless of whether the work volume is high or low. Appropriately prioritizes work activities. Responds to difficult situations with self-control and a positive attitude. Makes decisions independently and knows when to ask for assistance. Exercises good judgment and arrives at sound decisions.
Documentation is accurate, complete and legible.
Validates patient's demographic and payer information with patient/family and notifies Patient Access immediately if any corrections are needed. that Validates that all commercial/managed care discharges have authorization for status and level of care provided, notifies Dir of variances.
Provides Important Message follow up letter to Medicare patients per Tenet policy and under the direction of the RN Case Manger or SW (15% daily, Makes referrals for post-acute services under the direction of RN CM or SW staff utilizing the electronic Tenet Case Management system. 10 Provides patients and families with choices of post-acute per Tenet policy and completes documentation.
Responds to post-acute providers timely and completes referrals per Tenet policy
Documents and communicates all elements of the post-acute referral to the RN CM or SW, healthcare team, patient/family, post acute providers. Completes tasks as assigned by RN Case Manager and/or SW staff
Makes copies, send faxes, completes phone calls to arrange post-acute services, ensures appropriate hospital info is communicated to providers. Documents all referrals and tasks in the Tenet Case Management system per Tenet policy (70% daily, essential)
Ensures that payers have received all clinical information from the RN Case Manager
Provides pts and healthcare team info regarding resources,benefits available to the pt along with the economic impact of care options (5% daily
Adheres to dept structure,staffing,policies & procedures to comply with the CMS Conditions of Participation and Tenet policies (10% daily essential) Performs other duties as assigned
III. CUSTOMER SERVICE - G.E.M. PROGRAM (GO THE EXTRA MILE)
Takes responsibility for providing services every day.
2. Displays outstanding customer service skills:
• Greets all customers warmly
• Makes eye contact
• Introduces self and calls patients/ customers by name
Provides all assistance needed in a friendly and caring manner.
Looks for opportunities daily to "Go the Extra Mile" in not only meeting customer needs but exceeding expectations.
Displays sensitivity to an individual's race, color, religion, sex, sexual orientation, national origin, age, disability or any characteristic protected by law. Respects, accepts and anticipates spiritual and personal needs.
Compassionate to patients, families, visitors, physicians and co-workers.
• Demonstrates kindness, compassion, courtesy and respect.
Demonstrates good listening skills.
• Demonstrates a willingness to help.
Connection to patients, families, visitors, physicians and co-workers.
• Greets and performs tasks with a smile.
• Practices the 5 fundamentals of communication (AIDE-T) (Acknowledge, Introduction, Duration, Explanation, and Thank you).
• Practices professional telephone courtesy.
Communication to patients, families, visitors, physicians and co-workers.
• Responds to patient's complaints/patient issues take priority.
• Accepts responsibility for actions.
• Demonstrates communication excellence.
Caring and professional with patients, families, visitors, physicians and co-workers.
A team player and "spotlights" other members of the team.
Lends a helping hand to co-workers without being asked.
• Keeps the workplace clean and neat.
• Offers to escort visitors to their destination.
• Refrains from personal conversations in front of patients, families or visitors.
• Maintains a positive, professional attitude.
III. B. KEY SUCCESS FACTORS
ATTENDANCE- Employee reports to work each regularly scheduled workday. Accurately records all work time including meal periods.
PUNCTUALITY - Is ready for work at precise starting time and continues working until scheduled departure time. Returns on time from all break and meal periods.
GENERAL WORK HABITS - Readily accepts work assignments in a positive manner. Performs work that is accurate, timely, neat and consistent. Documentation is legible.
SAFETY-Keeps work area neat and maintains equipment in accordance with health and safety codes. Reports safety issues and equipment failures appropriately
APPEARANCE - Projects a professional image, follows the hospital dress code policy and/or department requirements. Wears hospital ID badge at CONFIDENTIALITY - Sensitive information including, but not limited to, patient records, charts, hospital documents and employee information is ANNUAL REQUIREMENTS - Completes annual requirements (PPD, health requirements, Annual Update, Ethics training, licensure and/or
IV. TRAINING AND EXPERIENCE
MANDATORY:
Prior case management experience, acute care hospital experience Excellent organizational skills, verbal and written communication skills Able to demonstrate problem solving, and computer literacy
PREFERRED:
High School diploma or equivalent Bachelor's degree
V. PHYSICAL REQUIREMENTS
Regularly required to sit, stand, walk, talk and hear
Use of fine motor skills-typing/data entry
Able to work in a faced paced clinical environment
