Inpatient Case Manager

Salary : $197,254.72 - $251,750.72 Annually
Location : Throughout the County of Santa Clara, CA
Job Type: Full-Time/Part-Time
Job Number: 25-S6D-A
Department: Santa Clara Valley Health Care - Valley Medical Center
Opening Date: 02/06/2025
Closing Date: 2/21/2025 11:59 PM Pacific
Bargaining Unit: 92

Description
Under limited direction, to assess, plan, coordinate, implement, facilitate, and monitor the delivery of required services, treatments, and resources for assigned patients of Santa Clara Valley Healthcare (SCVHC).
This classification is used throughout the Santa Clara Valley Healthcare and Hospital System, not just SCVHC.

Only applicants who provide proof of current certification as a Registered Nurse by the State of California, Department of Health Services certificate attached to their application will be accepted. All other applicants will be rejected.
The Power of WE: Together, we can make a greater impact. Bringing better care and expanding healthcare services across the community.

Santa Clara Valley Healthcare (SCVH) is the second largest public health care system in California and includes three acute care hospitals, 14 clinics and 60+ specialty and sub-specialty services. Our mission is to provide high-quality, accessible healthcare and excellent service to everyone in Santa Clara County.
Santa Clara Valley Medical Center - SCVMC is a full-service tertiary acute care teaching hospital with 699 licensed beds providing a wide range of specialized services, including Rehabilitation, Burn, Trauma, and NICU. SCVMC was ranked by U.S. News and World Report as #6 Rehabilitation Hospital in the nation and #1 in the West and designated as a 2024 High Performing hospital for Maternity Care, Heart Failure, Stroke, Hip Fracture, and Pneumonia.
O'Connor Hospital - O'Connor Hospital (OCH) is a 358 licensed bed acute care facility offering a full range of inpatient and outpatient medical, surgical and specialty programs to residents of Santa Clara County. It was founded in 1889 as one of the first hospitals in the county. OCH has grown significantly over the past five years in both its inpatient volume and its Emergency Department visits. Along with these volume increases other ancillary and clinical departments like imaging, lab, pharmacy, and respiratory have seen growth as well.
St. Louise Regional Hospital - Since 1989, St. Louise Regional Hospital (SLRH) has been caring for the residents in Santa Clara and San Benito Counties, offering a wide range of inpatient and outpatient medical specialties. SLRH has 93 beds, is a Designated Primary Stroke Center, and is the only acute care hospital in the area. Located in Gilroy, SLRH maintains a CALSTAR 2 emergency helicopter base on the premises.
Learn more about Santa Clara Valley Healthcare: https://www.scvh.org/home and follow us on: LinkedIn | www.linkedin.com/company/county-of-santa-clara/

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Typical Tasks

• Reviews and assesses assigned patients' medical and personal history, current status, psychological needs; diagnosis, prognosis, treatment plan and payer source;
  
• Interviews patient, family, and/or caregivers regarding home environment and support, prior level of function, financial resources, social supports and other factors likely affect care and/or discharge plan;
  
• Provides medical treatment education to patient, patient's family and other medical staff;
  
• Reviews and assesses, on an ongoing basis, assigned patients' charts for adherence to treatment plans;
  
• Acts as a liaison to and confers with staff of various disciplines to ensure completion of services and treatments with appropriate timeframes;
  
• Secures and negotiates resources to ensure multiple health care needs are met;
  
• Communicates with insurance companies and providers; prepares clinical documentation as required by payer source; justifies level of care and appeals denials for continued hospital stay, medical services, and dispositional services; provides coverage updates;
  
• Identifies and resolves situations and barriers causing delays in service, treatment, or discharge; and utilizes creativity in developing solutions;
  
• Intervenes when necessary to ensure the care provided is necessary and performed in a timely manner to avoid loss of revenue to the hospital and potential denial of payment by the provider;
  
• Researches, communicates and recommends, when appropriate, alternative, more cost effective, service delivery;
  
• Participates in interdisciplinary patient care conferences and patient team rounds;
  
• Confers with appropriate individuals in other specialty areas regarding patient treatment and service aspects;
  
• Documents patient progress;
  
• Develops, evaluates, and coordinates a comprehensive discharge plan in conjunction with the patient/family, physicians, nursing staff, social services and other healthcare providers and agencies; identifies potential difficulties in community reintegration where appropriate;
  
• Coordinates and ensures procurement of required patient medical equipment and may train patient's support system in use;
  
• Collaborates with other staff or assists with scheduling follow up care, as necessary;
  
• Serves as member of various hospital committees;
  
• Represents SCVMC in State hearing process for those patients refused admittance to a skilled nursing facility;
  
• Researches criteria within utilization computer system in order to monitor inpatient level of care and to facilitate and assist doctor-to-doctor and peer-to-peer review between Hospital and health plan;
  
• Keeps abreast of payer guidelines and specific licensure requirements;
  
• Assists in the hiring process and training of new staff;
  
• Participates in special project development and implementation;
  
• May be assigned as a Disaster Service Worker, as required;
  
• Performs other related duties as assigned.

Employment Standards

Sufficient education, training and experience to demonstrate possession and direct application of the following knowledge and abilities.

Training and Experience Note: The required knowledge and abilities are attained through two (2) years of full-time experience comparable to a Clinical Nurse II in the County of Santa Clara in an acute hospital setting.

Special Requirement:
Graduate of an approved nursing program and licensed as a Registered Nurse (RN) in the State of California prior to appointment.

Possession of a Bachelor of Science in Nursing (BSN) and/or current patient case management experience is desirable.

Knowledge of:

• Medical terminology used in diagnosis, level of care, disease continuum, and treatment;
  
• Patient evaluation, assessment and communication techniques;
  
• Federal and State health care laws and regulations appropriate to the operation of California hospitals;
  
• Care management delivery systems;
  
• Various acute care hospital specialties;
  
• Basic training techniques;
  
• Financial processes for various private and public funding sources;
  
• Private and governmental insurers and medical assistance programs;
  
• Available alternative patient services and treatments;
  
• Acute care hospital operations, organization, systems and service areas;
  
• Record keeping and reporting procedures;
  
• Computer systems that provide evidence-based clinical criteria and common office computer applications;
  
• Various criteria for determining level of care and current standards in medical, therapy, and nursing practice.

Ability to:

• Communicate orally and in writing in an effective, tactful, and assertive manner, including with distressed or emotional individuals;
  
• Keep abreast of, understand, and interpret healthcare laws, regulations, and procedures;
  
• Work independently and under pressure, meet deadlines, adapt to varying circumstances and use sound judgement in the performance of duties;
  
• Develop and maintain effective working relationships with patients, families, peers, medical professionals, and all contacted in the course of work;
  
• Reason logically and creatively, and utilize a variety of analytical techniques to resolve complex and specialized issues;
  
• Educate and train others;
  
• Perform research, evaluate data, and make recommendations;
  
• Work effectively and in cooperation with other organizations, departments and personnel;
  
• Keep abreast of current, available, alternative treatments and services;
  
• Resolve complex interdisciplinary problems in an expeditious and effective manner.

Physical Requirements

Ability to work irregular hours, weekends, and holidays, as necessary.
The County offers comprehensive first-class medical, dental, and vision benefits plans for County employees and their dependents, including plans with no deductibles, no co-pays, no co-insurance, and no prescription drug co-pays. Learn more

The County also offers generous paid time off with significant vacation, sick time, and 13 paid County holidays annually! Details are included in the with the bargaining unit applicable to the job classification.

In addition to the amazing perks above, the County also offers the additional benefits below.

Retirement Benefits
The County offers robust retirement plans including a (similar to the private sector's 401(k) plan) and the In addition to lifetime retirement income available through the CalPERS pension plan, the 457(b) Deferred Compensation plan provides a great way to save for retirement and supplement the defined benefit pension available to employees. These plans help our employees build a plan for their future and contribute to their family's long-term financial well-being.

Health Flexible Spending Account
The empowers employees to manage healthcare expenses efficiently with tax-free contributions (up to $3,200 for the 2024 calendar year). Secure tax-free solutions for your healthcare expenses and enjoy the flexibility to manage your healthcare finances effectively with the HFSA.

Dependent Care Assistance Program (DCAP)
The enables employees to utilize tax-free funds for dependent care services, facilitating a convenient and cost-effective approach for managing your dependent care expenses. The County also offers the , an employer-funded DCAP, for employees with annual income under $120,000.

Life and AD&D
The County offers life and disability benefits including , Insurance, These benefits ensure financial security and income support when you and your family need it most.

Employee Assistance Program (EAP)
The County prioritizes employee mental health and well-being and offers a top-tier through Concern providing confidential counseling sessions covering stress, anxiety, relationships, grief, as well as financial/legal services, personal coaching, child and elder care referrals, and comprehensive crisis support.

Employee Wellness
The offers free wellness programing, fitness classes and resources; including Elevate My Wellness an all-in-one platform designed to elevate your well-being journey.

Education Reimbursement
A generous program is available, including Education Reimbursement for employees seeking additional training and professional development.

NOTE: Benefit and Retirement information may vary from bargaining unit to bargaining unit. Due to changes in State Law, current pension provisions described in the union contracts are not automatically applied. Specific pension benefits for new hires who start on or after January 1, 2013 may be different than indicated in the union contracts.

Click here to access all Memoranda of Understanding and most recent Summary of Changes.
01

Please answer the following questions. Completion of the following supplemental questions is REQUIRED for your application and is an integral part of the evaluation process. Initially, it will be used to determine minimum qualifications. For those applicants meeting the employment standards, this information will be critical in the subsequent competitive assessment to identify those candidates to be invited to continue in the examination process. Your responses to the questions may also be reviewed and scored in a Competitive Rating evaluation process based on pre-determined rating criteria. Your answers should be as complete as possible, as no additional information will be accepted from applicants once the Competitive Rating evaluation has begun. Please include the name of employer, job title, dates of employment and number of hours worked per week for questions asking about your experience. A response of "see resume" or "see application" will deem your application incomplete. Vague, incomplete or non-responsive answers could result in no or low scores in a competitive rating process. Do you understand this requirement?

• Yes
• No

02

How many years of experience comparable to a Clinical Nurse II or higher in the County of Santa Clara in an acute hospital setting do you have?

• None
• Less than one year
• One to less than two years
• Two to less than three years
• Three to less than four years
• Four to less than five years
• Five years or more

03

Describe in detail your experience comparable to a Clinical Nurse II or higher in the County of Santa Clara in an acute hospital. Please include the name of the employer, hospital name if applicable, job titles, dates of employment, number of hours worked per week, and professional administrative duties performed. If none, please type "N/A".
04

Have you graduated from an approved nursing program?

• Yes
• No

05

Do you have an active California Registered Nurse License without restrictions?

• Yes
• No

06

Please list your California Registered Nursing license number and the expiration date. If you do not have any write "N/A."
07

Do you possess a Bachelor of Science in Nursing (BSN)?

• Yes
• No

08

Are you willing to work in different units and on weekends, holidays, and on variable shifts?

• Yes
• No

09

Which areas do you have experience working in? (Select all that apply)

• Acute Care (Inpatient)
• Outpatient
• Other
• None

10

Do you have Case Management Experience?

• Yes
• No

11

Please describe your experience working as a Case Manager. Please include the name of the employer, job title, job duties, dates of employment, and the number of hours worked per week. If none, indicate "N/A".
12

What is your experience working in a County or public hospital? If none, indicate N/A.
13

Do you have experience working in Utilization Review?

• Yes
• No

14

Please describe your experience in Utilization Review. Please include the name of the employer, job title, job duties, dates of employment, and the number of hours worked per week. If none, enter 'N/A'.
15

Please select all of the programs/procedures/systems that you have experience using (click all that apply):

• EPIC
• Interqual
• Allscripts
• Other
• None

16

Describe your experience in each program/system that you selected in the previous question, (Interqual, EPIC, Allscripts, Other).Include the name of the program/system, name of employer(s), job title(s), dates of employment, the number of hours worked per week, job duties performed. If you do not have any write "none."
17

Describe your level of experience documenting in an electronic medical record platform. If none, enter 'N/A'.
18

Please complete this survey carefully. Your responses will determine whether or not you will be referred for a specific position (i.e., geographical location). Please place a mark next to the location(s) in which you would be willing to work.

• Care Management
• Facilities
• Medical Examiner/Coroner
• Public Health
• Custody Health Services
• Behavioral Health Services
• Community Health Services
• Emergency Health Services
• Valley Health Plan
• Hospital System - Valley Medical Center
• Hospital System - O'Connor
• Hospital System - Saint Louise Regional
• Hospital System - De Paul Medical Center
• Hospital System - Regional Medical Center

19

How did you find out about this job?

• Contacted by County Recruiter
• Contacted by a Recruitment Firm
• County Employee Referral
• County of Santa Clara Career Website
• County of Santa Clara Job Interests Email Notification
• Facebook
• Instagram
• LinkedIn
• Indeed
• Virtual Job Fair
• In Person Job Fair
• In-Person Networking Professional Event
• Virtual Networking Event
• Community Event
• Glassdoor
• Governmentjobs.com
• Professional Association
• Search Engine (Google, Bing, online search, etc.)
• Hospital Website: SCVMC, O'Connor Hospital, St. Louise Regional Hospital Website
• Handshake
• Student Career Center
• County Text Message
• Other (Specify in the next question)

20

If you selected an event/fair or other in the question above, please specify. If not, type n/a.
Required Question