Care Manager Lead (RN) : Care Management

Hoag•Newport Beach, CA

14h

About The Position

The Care Manager Lead (RN) utilizes clinical expertise, patient assessments, and insurance payer requirements to coordinate patients’ needs through the continuum of care including post-acute care and discharge plans. This role works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care. Resource utilization is considered when coordinating the patients’ needs through the continuum of care. May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support. May review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans. May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing. May provide psychodynamic intervention and crisis counseling to support patients and families. May educate patients and families on their healthcare options and connect them with resources. Documents pertinent patient issues, contacts and discharge plans on the medical records. Is a mandated reporter for elder, child, and spousal abuse. Performs other duties as assigned. If in a Magnet facility, participates in Magnet councils and acts as a preceptor in the Nurse Care Manager intern program Provides training and clinical supervision to pre-licensed staff as needed. The Lead will provide input to performance evaluations, scheduling, and monitoring workflows. Responsible for fiscal goals, budget, and productivity. Performs other duties as assigned. Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year. For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy. Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes. Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California. To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/. Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.

Responsibilities

Utilizes clinical expertise, patient assessments, and insurance payer requirements to coordinate patients’ needs through the continuum of care including post-acute care and discharge plans.
Works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care.
Resource utilization is considered when coordinating the patients’ needs through the continuum of care.
May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support.
May review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans.
May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing.
May provide psychodynamic intervention and crisis counseling to support patients and families.
May educate patients and families on their healthcare options and connect them with resources.
Documents pertinent patient issues, contacts and discharge plans on the medical records.
Is a mandated reporter for elder, child, and spousal abuse.
Performs other duties as assigned.
If in a Magnet facility, participates in Magnet councils and acts as a preceptor in the Nurse Care Manager intern program
Provides training and clinical supervision to pre-licensed staff as needed.
The Lead will provide input to performance evaluations, scheduling, and monitoring workflows.
Responsible for fiscal goals, budget, and productivity.
Performs other duties as assigned.