Case Manager Continuing Care Social Work (Bilingual /Spanish) - Bellflower

$101,700 - $131,560/Yr

Kaiser Permanente - Bellflower, CA

Full-time - Entry Level

Bellflower, CA

10,001+ employees

Ambulatory Health Care Services

About the position

The Case Manager for Continuing Care Social Work is responsible for coordinating patient care for specific geriatric and high-risk populations. This role involves collaborating with physicians and healthcare providers to develop and implement comprehensive treatment plans, ensuring compliance with regulations, and facilitating continuity of care across various healthcare settings. The position requires bilingual proficiency in Spanish and a strong understanding of case management principles.

Responsibilities

• Plans, develops, assesses and evaluates care provided to members.
• Evaluates and develops baseline medical and psychosocial evaluations and individualized patient care/treatment plans in conjunction with primary care and specialist physicians.
• 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 plans focused on self-management; delivers patient/family education specific to a disease state.
• Implements strategies to target/assess risk factors 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 members to follow prescribed courses 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.

Requirements

• Graduate of an academic institution accredited by the Council on Social Work Education and a Master's degree in Social Work.
• Demonstrated knowledge of case management, discharge planning, transfer coordination; TJC and other federal/state/local regulations.
• Bilingual (English/Spanish) Level II required.

Nice-to-haves

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

Benefits

• Competitive salary range of $101,700 - $131,560 per year.
• Full-time employment with a day shift schedule.
• Opportunities for professional development and training.