Care Manager I (RN): Irvine Care Management
About The Position
The Care Manager I (RN) in Utilization Review coordinates patients’ needs across the continuum of care, from pre-admission through post-discharge planning. The role collaborates with physicians, nurses, clinical staff, and community agencies to identify and arrange appropriate care. The Care Manager reviews clinician assessments and patients’ financial, family, and psychosocial support to develop comprehensive care and discharge plans. The role may focus on discharge planning, utilization review, and/or psychosocial support. It may also involve reviewing records to assess admission status, level of care, payer source, and utilization-review contracts to validate billing. The Care Manager may provide psychodynamic intervention and crisis counseling, educate patients and families about healthcare options, and connect them with resources. The position documents pertinent patient issues, contacts, and plans in medical records and is a mandated reporter for elder, child, and spousal abuse. The Community Care role provides care management support to high-risk, homeless, and mental health populations. The ED Care Manager role also collaborates on care management for consulted geriatric patients age 65 and older, addressing their physical, emotional, financial, and social well-being. Other duties may be assigned.
Requirements
- Fulfill mandatory stroke education requirements per certification agency.
- For the Care Manager (RN) position, hold a Bachelor’s degree in Nursing (BSN), subject to the stated exception for Magnet-designated facilities.
- Hold a Registered Nurse (RN) license for the Care Manager I (RN) position.
Nice To Haves
- One year of experience in an acute health care setting is preferred.
Responsibilities
- Coordinate patients’ needs across the continuum of care, including pre-admission and post-discharge planning.
- Collaborate with physicians, nurses, clinical staff, and community agencies to identify and arrange appropriate care.
- Review clinician assessments and patients’ financial, family, and psychosocial support to develop comprehensive care and discharge plans.
- Focus on discharge planning, utilization review, and/or providing psychosocial support, as assigned.
- Review records to assess admission status, level of care, payer source, and utilization-review contracts to validate billing.
- Provide psychodynamic intervention and crisis counseling to support patients and families, as applicable.
- Educate patients and families about healthcare options and connect them with resources.
- Document pertinent patient issues, contacts, and plans in medical records.
- Report suspected elder, child, and spousal abuse as a mandated reporter.
- In the Community Care role, provide care management support to high-risk, homeless, and mental health populations.
- In the ED Care Manager role, collaborate on care management for consulted geriatric patients age 65 and older, addressing their physical, emotional, financial, and social well-being.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
