If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Day - 08 Hour (United States of America)Why work at Stanford Medicine | Stanford Health Care (SHC)?Are you a seasoned RN Case Manager? Here is your opportunity to work with the Timely Discharge Department at its inception.You can put your bedside RN experience to great use in case management working in conjunction with the medical teams, third-party companies, and patients with the goal of best outcomes for continuity of care.This is an onsite role.Benefits begin the first day of the month following employment eligibility.Our core benefits include medical insurance, dental insurance, vision insurance, an employee assistance program, savings and spending accounts, disability, life and accident insurance, and COBRA. For medical insurance, you have the choice of three generous health plans through Stanford Health Care Alliance, Aetna, or Kaiser Permanente. Each plan includes 100% coverage for preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices. And so much more – generous leave & time off, Wellness Program, special programs, educational assistance, and adoption assistance!This is an onsite Stanford Health Care job.A Brief OverviewCase Managers are licensed nursing professionals responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients. Major responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services; and ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements. Case Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and patient care and participate in program development and quality improvement initiatives. In their role, Case Managers, by applying guidelines and collaborating with multidisciplinary teams, influence and direct the delivery and quality of patient care. A hospital-based case management system has as its primary goal to ensure the most appropriate use of services by patients and, toward that end, to avoid duplication and misuse of medical services, control costs by reducing inefficient services, and improve the effectiveness of care delivery. Objectives are to facilitate timely discharge; prompt, efficient use of resources; achievement of expected outcomes; collaborative practice; coordination of care across the continuum; and performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care practice in that it is not intended to provide direct patient care; rather, a Case Manager will be assigned to specific patients to ensure that the medical services and treatments required are accomplished in the most financially and clinically efficient manner.LocationsStanford Health Care (Palo Alto, CA; onsite)What you will doCoordination of Care -- Manages each patient's transition through the system and transfers accountability to the appropriate person upon entry into another clinical service or discharge.Discharge Planning -- Coordinates and facilitates timely implementation of discharge plans for assigned patients with complex needs in collaboration with other interdisciplinary team members; arranges follow-up care as appropriate.Education/Consultation -- Acts as an educational resource and provides consultation to patients and their families, hospital medical personnel regarding the discharge planning process and applicable regulatory requirements; educates the staff on case management; and provides specific information related to case types.Lead Work -- May lead the work of administrative/clinical support staff responsible for assisting with case management for an assigned patient caseload.Other -- Participates in department program planning, goal setting, systems development and process improvement; participates in department and hospital committees and task forces; develops and maintains documentation of findings, discharge arrangements, and actions taken according to departmental guidelines; prepares and maintains records as required; collects, analyzes and reports on data for utilization, quality improvement, compliance, and other areas as assigned.Patient Assessment/Plan of Care -- Functions as a resource to and collaborates with physicians, social workers, nurses, and other interdisciplinary team members to assess, plan, and coordinate patient care needs and/or performs patient assessment and develops a plan of care to assure consistent, timely, and appropriate care is provided in a patient-focused manner.Quality Improvement -- Participates in quality improvement activities by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent data collection; participates in clinical process improvement teams within the department, service lines, and hospital.Third-Party Reimbursement -- Collects, analyzes reports and reviews patient information with third-party payers to assure reimbursement for patient services/procedures. Communicates with review organizations/payers to provide requested clinical and psychosocial information to assure reimbursement.Utilization Review -- Reviews prospectively, concurrently and retrospectively all inpatients for appropriateness of admission, level of care, and determines appropriate length of stay. Monitors patients' length of stay and collaborates with physicians to ensure resource utilization remains within covered benefits and are appropriate in relationship to the patient's clinical and psychosocial needs; plans and implements (through multi-disciplinary meetings or rounds) strategies to reduce length of stay, reduce resource consumption, and achieve positive patient outcomes analyzes and addresses aggregate variances as well as variances from individual patients and shares this information with staff, physicians, and administration.Education QualificationsBachelor's Degree from an accredited college or university.Experience QualificationsThree (3) years of progressively responsible and directly related work experience PreferredRequired Knowledge, Skills and AbilitiesAbility to collect and record data, evaluate data and statistics, and maintain effective reporting systemsAbility to develop and perform patient assessment and plan of careAbility to monitor and assure the patient's access to the appropriate level of care; the right health care providers; and the correct setting and services to meet the patient's needs; promote coordination and continuity in patient health careAbility to provide age-appropriate assessments, interpretation of data, and delivery of interventionsAbility to provide appropriate patient care and clinical information when patients are admitted, referred, transferred, or dischargedAbility to remain knowledgeable regarding available treatments and servicesAbility to resolve conflicts and/or negotiate with others to achieve positive results; establish and maintain effective interpersonal relationshipsAbility to understand, interpret and apply complex federal and state hospital compliance laws, rules, regulations and guidelinesAbility to work effectively with individuals at all levels of the organizationKnowledge of available patient services and treatmentKnowledge of current theories, principles, practices, standards, emerging technologies, techniques and approaches in the nursing profession, and the health care system, and the responsibility and accountability for the outcome of practiceKnowledge of evaluation and assessment techniquesKnowledge of financial processes of various private and public funding sources for health care services/proceduresKnowledge of hospital operations, organization, systems and procedures and laws and regulations pertaining to the operation of hospitals in CaliforniaKnowledge of medical terminology and related levels of care and treatmentKnowledge of the full continuum of care available to patients, interrelationships of the care components, and their effective integrationKnowledge of the models of case management, including the principles and practices of discharge planning, utilization review, and quality assurance/improvementKnowledge of the variables that affect the processes and outcomes of patient health careLicenses and CertificationsNursing / RN - Registered Nurse - State Licensure and/or Compact State Licensure requiredThese principles apply to ALL employees:SHC Commitment to Providing an Exceptional Patient & Family ExperienceStanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.You will do this by executing against our three experience pillars, from the patient and family’s perspective:Know Me: Anticipate my needs and status to deliver effective careShow Me the Way: Guide and prompt my actions to arrive at better outcomes and better healthCoordinate for Me: Own the complexity of my care through coordinationEqual Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.Base Pay Scale: Generally starting at $72.55 - $96.15 per hourThe salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.At Stanford Health Care, we seek to provide patients with the very best in diagnosis and treatment, with outstanding quality, compassion and coordination. With an unmatched track record of scientific discovery, technological innovation and translational medicine, Stanford Medicine physicians are pioneering leading edge therapies today that will change the way health care is delivered tomorrow.As part of our spirit of discovery, we also leverage our deep relationships with luminary Silicon Valley companies to develop new ways to deliver preeminent patient care.Learn about our awards ( and significant events ( .