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Behavioral Health, Social Services & Spiritual Care

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Case Manager Continuing Care SW PD

Location: Los Angeles, CA Additional Locations:
Job Number: 770430 Date posted: 02/08/2019
Description:

Coordinates with physicians, staff, and non-Kaiser providers/facilities regarding patient care/population based management for patients in specifically defined geriatric or other specifically defined patient populations (e.g., patients with a specific chronic disease, high risk patients) in order to plan and implement a comprehensive, mutli-disciplinary approach to manage health conditions, utilization of resources and protocols, patient self-care, implementation and evaluation of treatment plan across the care continuum (primary, secondary, tertiary and continued care). In conjunction with physicians, develops treatment plan, monitors care, makes recommendations for alternative levels of care, identifies cost-effective protocols and care paths and develops guidelines for care that may require coordination across systems of multiple providers/services.



Essential Functions:
- Plans, develops, assesses and evaluates care provided to members.
- In conjunction with primary care and specialist physicians, evaluates and develops baseline medical and psychosocial evaluations and individualized patient care/treatment plans.
- Recommends alternative levels of care and ensures compliance with federal, state, and local requirements.
- Makes assessments of physiological and or functional status utilizing protocols.
- Initiates appropriate diagnostic testing/screening and interventions.
- Develops individualized patient/family education plan focused on self-management; delivers patient/family education specific to a disease state.
- Implements strategies to target/assess risk factors and achieve and ensure patient follow-up according to clinical and strategic measures/outcomes.
- Produces population based reports on outcomes specific to defined patient populations.
- Participates with healthcare team/providers in actualizing outcomes by planning, evaluating and implementing decisions and strategies to achieve predetermined cost, clinical, quality, utilization and service outcomes.
- Develops and maintains case management policies and procedures.
- Coordinates care/services with utilization and/or quality reviewers and monitors level and quality of care.
- Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.
- Consults with internal and external physicians, health care providers, discharge planning and outside agencies regarding continued care/treatment or hospitalization or referral to support services or placement.
- Arranges and monitors follow-up appointments.
- Encourages member to follow prescribed course of care (e.g., drug therapy, physical therapy).
- Makes referrals to appropriate community services and outside providers.
- Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.
- Develops and collects data; trends utilization of health care resources.
- Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.
- Coordinates transmission of clinical and benefit treatment to patients, families and outside agencies.
- Acts as liaison for outside agencies, non-plan facilities, and outside providers.
- Coordinates repatriation of patients and monitors their quality of care.

Basic Qualifications:
Experience
- N/A.
Education
- Graduate of an academic institution accredited by the Council on Social Work Education and a Master's degree in Social Work.
License, Certification, Registration
- N/A.
 
Additional Requirements:
- Demonstrated knowledge of case management, discharge planning, transfer coordination; TJC and other federal/state/local regulations.
- Must be able to work in a Labor/Management Partnership environment.
 


Preferred Qualifications:
- Minimum two (2) years of case management experience with the population to be case managed preferred.
- Current and valid LCSW highly preferred.


- Minimum of 1 year UM experience preferred.

Primary Location: California,Los Angeles,Mental Health - A 765 W. College St. Scheduled Weekly Hours: 0 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: 8:00 AM Working Hours End: 5:00 PM Job Schedule: Per Diem Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Non-Union, Non-Exempt Job Level: Individual Contributor Job Category: Behavioral / Mental Health Department: Utilization Mangement Travel: No Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

About Behavioral Health, Social Services & Spiritual Care Careers

Behavioral Health, Social Services & Spiritual Care Careers

Backed by a committed interdisciplinary team of health care professionals, you'll provide high-quality treatment for patients with behavioral health and/or bio-psychological concerns, including those in psychological crisis.

With the strength of our network at your fingertips, you'll be sure your patients receive prompt, appropriate referrals across our organization with no barriers to the continuity of care. Opportunities and specialty settings range from substance abuse to social work and autism to eating disorders.

Opportunities:

  • Alcohol and Substance Abuse Counselors
  • Case Managers
  • Clinical Psychologists
  • Clinical Social Workers
  • Health Educators
  • Marriage and Family Therapists
  • Medical Social Workers
  • Psychiatric Social Workers

Specialty Settings:

  • Addiction Medicine/Chemical Dependency
  • Autism
  • Chronic Pain Management
  • Eating Disorders
  • Employee Assistance
  • Geriatrics
  • Help Line/Psychiatric Call Center
  • Home Health
  • Hospice
  • Medical Social Work
  • Neuropsychology
  • OB/GYN
  • Palliative Care
  • Pediatrics
  • Psychiatric Emergency Team (PET)
  • Psychiatry (Adult, Adolescent & Child)
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