Pacific Medical Centers RN Case Manager - Uniformed Services Family Health Plan in Seattle, Washington
PacMed is looking for a Registered Nurse - Case Manager at Pacific Medical Centers in Seattle, WA.
The RN Case Manager coordinates care for Pacific Medical Centers' Managed Care patient in order to assure cost effective, appropriate utilization of health care resource. Nurse Case Manager manages, directs, and coordinates the entire spectrum of care for patient throughout a variety of settings, both inpatient and outpatient. This position assists physicians (internal and external) with management and coordination of care.
In this position you will:
Case manages USFHP patient population during inpatient or outpatient stays for mental health, chemical dependency, and eating disorder issues. Collaborates with USFHP case management staff on decisions regarding ongoing care.
For all external USFHP referrals for psychiatry and/or therapy, provides ongoing review of outside care.
Makes recommendations to the Medical Director regarding continuing outside care for specialty services not available within PMC, or for services for patients living outside the Seattle area.
Collaborates with physicians to identify the plan of care for admission and appropriate disposition of patients from hospital, including the expected outcome(s) of treatment.
Assesses patients and facilitates a decision to determine disposition of patients on discharge. Works with behavioral health, chemical dependency, residential treatment and eating disorders treatment facilities’ discharge planners to maximize outcomes.
Advises patients and families regarding benefits, resources, and home management options.
Educates and directs providers both within and outside the Pacific Medical system regarding benefits and utilization of services; directs case managers from outside facilities regarding: use of benefits and discharge planning options; consults with USFHP Medical Director regarding complex cases and discusses appropriateness of hospitalization or care in treatment facilities; identifies issues with Pacific Medical system to facilitate patient care (barriers to patient care).
Is responsible for managing complex patients in the outpatient setting utilizing homecare, hospice, DME and other appropriate agencies. Recommends care plan for high risk patients in the outpatient setting including communication with physicians, nurses, homecare providers or others as applicable.
Is accountable for appropriate referrals for homecare. Assesses and determines homecare for patients when hospitalized. Responsible for ordering homecare. Maintains a comprehensive knowledge of benefits, services, agencies and community resources available.
Acts as a resource for managed care plans; utilizes knowledge of managed care plans administrated by Pacific Medical Centers and Medicare benefits and guidelines to coordinate patient care; advises patients and families regarding benefits, limitations, and appropriate use of resources.
Oversees the quality of care in inpatient setting; identifies and reports quality of care issues to the Medical Director, Quality Manager, and Utilization Directors both for inpatient and outpatient based services; consults and advises Risk Manager as needed.
Current Washington State Registered Nurse License
Five (5) years clinical experience
Two (2) years in a Behavioral Health setting
Cardiopulmonary Resuscitation (CPR) or Current Basic Life Support (BLS) certification within 6 months of hire
Preferred qualifications :
Bachelor of Science in Nursing (BSN)
Certified Case Manager experience
Experience in utilization review/case management
About Pacific Medical Center:
Pacific Medical Center is an expanding network of outpatient clinics providing primary and specialty care to the greater Seattle area and employing more than 150 providers representing most medical specialties. Pacific Medical Centers
is affiliated with Providence Health & Services, which operates 28 exceptional not-for-profit hospitals and more than 350 clinics across the West. With hundreds of physician and advanced practice provider opportunities in virtually all specialties at any given time, Pacific Medical Centers and Providence offer diverse locations, lifestyles and practice models. Find what you are looking for in your next practice opportunity with Pacific Medical Centers!
Learn more at www.pacmed.org/providerjobs .
We offer a full comprehensive range of benefits — see our website for details —
Our mission is to provide respectful, high-quality, patient-focused healthcare to each person and to the communities we serve.
Quality and respect. These are the words Pacific Medical Centers (PacMed) employees live and work by. PacMed is a private, not-for-profit, primary and integrated multispecialty health care network with 10 outpatient clinics across the Puget Sound region and more than 175 primary and specialty care providers. Affiliated with the Providence Health & Services system, PacMed provides patient-focused health care — and even same-day appointments — to patients in King, Snohomish and Pierce counties. We provide immediate access to cutting-edge technology, first-class facilities and board-certified specialists, many of whom have been listed as among “Seattle’s Best Doctors.”
Pacific Medical Centers, PacMed, and their Affiliates' (collectively “PacMed”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. PacMed does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Job Category: Nursing - Other
Req ID: 251241