Case Manager Principal Responsibilities: CLINICAL
• Case Manager coordinates patient care specific to meet patient, payor and Center needs for patient outcome, cost and communication.
• Conducts pre-admission on-site assessments to ensure clinically appropriate admissions in accordance with Federal, State and Company requirements.
• Ensures continuity of care appropriate to meet patient, payor and Company requirements.
Case Manager ADMINISTRATIVE
• Supports the overall goals of the Company and the Center.
• Determines resource utilization specific to patient care needs, outcome expectations, payor and Company requirements.
• Participates in negotiating coverage as assigned.
• Ensures exchange of essential information, i.e., payor feedback, clinical outcomes, therapy utilization for the provision of quality patient service.
• Attends all Center or Company required inservices and meetings.
• Ensures all documentation necessary for quality case management is maintained according to Federal, State and Company requirements.
Case Manager QUALIFICATIONS
• Current licensure in State in which practicing.
• Strong administrative and organizational skills.
• Minimum 2 years experience in case management.
• Bachelors degree in health care field preferred.
Case Manager CONSUMER SERVICE
• Presents professional image to consumers through dress, behavior and speech.
• Adheres to Company standards for resolving consumer concerns.
• Ensures that all patient/resident rights are protected.

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Generally, include those functions that account for 10% or more of the work, i.e., key items that contribute significantly to the achievement of the job. The functions should add up to 100%. % of time Essential Function (Yes/No) Key Responsibilities (To be completed by Supervisor) 10 Yes Screening Identifies the needs and responses of patients to medical regimen and treatment through observation of symptoms, emotional state, and cultural and socioeconomic backgrounds and response to medical regimen and treatment. Recognizes and reports specific physical and emotional conditions/needs/concerns of the Patient to appropriate members of the health care team. Alerts a provider of unusual observations of patients to facilitate immediate attention, e.g., chest pain, shortness of breath, allergic reactions. 5 Yes Planning Works cooperatively and participates with the healthcare team to discuss patient’s alternatives to health care services and to develop short- and long-range goals to meet the patient’s needs. 20 Yes Implementation/Evaluation Provides individualized nursing care which responds to the growth and developmental needs of patients and demonstrates an understanding of the range of treatment required by the patient. Demonstrates ability to provide appropriate care based on the needs of a specific individual, including that individual’s age. Adult (19 – 64 years) Geriatric (65+ years) Sets up exam room and performs intake process.Provides for physical and emotional privacy. Prepares for and instructs patients about specific diagnostic and therapeutic procedures and treatments. Assists as needed with diagnostic and therapeutic procedures and treatments. Uses appliances and equipment correctly and maintains safe practice. Administers medication and documents accurately. Maintain current knowledge of pharmacology and competency in modes of administration. Accurately documents in the patient’s electronic medical record following the nursing process which include patient complaints, nursing observations, interventions and care plan, nursing actions/teachings performed and patient response to the action. Responds appropriately in emergencies.Is knowledgeable about the contents of the code blue cart and/or the emergency kits and can initiate and assist in CPR.Understands the procedures for medical emergencies, code blue and other emergency/disaster situations. Complies with all Ambulatory Services and Medical Center policies and procedures for infection control, safety, administrative and clinical practice.Complies with activities mandated by JCAHO/Title 22/NCQA. Completes annual competency testing as specified by the individual practice. Assists in reviewing in-basket messages and assists in completing messages as appropriate 10 Yes Advocacy/Education Provides patients with the necessary information to make informed decisions utilizing available resources and making referrals appropriately.Informs patients/families about services available at UCSF Medical Center and in the community.Utilizes and maintains updated educational resources. Provides and reinforces patient health teaching by utilizing language which patient and family can understand. Verifies patient/family understanding through return demonstration, verbal, physical or written. 5 Yes Performance Improvement Participates in Performance Improvement (PI) activities. Makes recommendations regarding PI topics or problems; and assists in data collection. Reports and follows up on issues that affect environment and safety 5 Yes Self-Development/Professionalism Attends classes, conferences, workshops, and staff meetings applicable to practice needs.Shares information from programs attended. Attends and participates in staff meetings. Complies with work-related policies, including license renewal, annual PPD, CPR certification, use of benefit time, and dress code including identification policy. Contributes to the orientation and learning experiences of other members of the health care team. Complies with departmental staff scheduling guidelines and HBS timekeeping policy, i.e. starts work as scheduled, completes work in a timely manner, notifies Administrative Nurse of time off requests as prescribed in the organizational policy 45 Yes Clinical Sets up exam rooms and performs intake process and assist patients in preparation for exam and/or procedure. Prepares for and instructs patients about specific diagnostic and therapeutic procedures. Evaluates and documents patient’s response to nursing care. Performs routing clinical functions, including but not limited to vital signs, height, weight, allergies, history, and documentation of chief complaints. Documents use of interpreter as appropriate. Work with interpreting services to facilitate interpreter participation for medical appointments in person, by phone or by video if available. Assists Nurses and Providers and patients in preparation for exam and/or procedures. Successfully completes all appropriate competencies to perform or assist with procedures as required for the department specialty and determined by the Clinical Manager—which may include but not limited to: Allergy Injections Allergy skin prick testing Administration of oral challenges Vaccine administration Acts as a chaperone as needed for medical providers Transports patients as directed to ensure their safety Monitors patient flow in and out of the clinic. Participates in updating mandatory logs (i.e.: temperature log, disaster cabinet log, crash cart log, aed log) Completes referrals to other providers as ordered by the physician Obtains authorizations from insurers for medications Performs clinical activities in an accurate and timely manner Assist physician staff in writing and sending out patient communications Complies with all Ambulatory Services and Medical Center policies and procedures for infection control, safety, administrative and clinical practice. Complies with activities mandated by JCAHO/Title 22 Ensures all medication cabinets remain locked at all times 0 0 0 0 100% (To update total %, enter the amount of time in whole numbers (without the % symbol - e.g., 15, 20) then highlight the total sum (e.g., 1%) at the bottom of the column and press F9. The total sum should add up to 100%.) Qualifications Required qualifications: 6 – 12 months minimum experience in an ambulatory setting. Recent experience in an Infectious Disease clinic. Familiarity with the process of prior authorizations to obtain specialty medications. Must have worked in a medical team consisting of several providers and an administrative assistant, knowing in-basket management, assisting with medication refills, coordinating services, and scheduling appointments and procedures Strong computer skills and use of Microsoft Office. Ability to prioritize work efficiently and independently, demonstrating strong self-initiative Excellent communication with patients and all levels of personnel with excellent writing skills. Excellent organizational and problem-solving skills. Demonstrated ability to use electronic medical records. This position requires flexibility to orient and work at all UCSF Medical Center locations. Graduated from an accredited vocational nursing program with a certificate. Preferred Qualifications Experience with ID and OPAT (Outpatient Parenteral Antibiotic Therapy) Experience performing allergy procedures Experience with telephone triage. Required Licenses/certifications Current California Vocational Nursing Licensure Current American Heart Association BLS certificate About UCSF ABOUT US The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences. We bring together the world’s leading experts in nearly every area of health. We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells. Pride Values UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence – also known as our PRIDE values . In addition to our PRIDE values, UCSF is committed to equity – both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available here . Join us to find a rewarding career contributing to improving healthcare worldwide. Equal Employment Opportunity The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law. Salary Information The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html