Care Manager Lead (RN) : Care Management

Hoag•Newport Beach, CA

13d

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.

Requirements

Bachelor’s or Master’s degree in Nursing (BSN/ MSN) required.
Five (5) years’ of clinical experience in an acute healthcare system environment required.
One (1) year supervisory experience, preferably in an acute healthcare system required.
Strong background in psychosocial assessments and managing chronic and acute disease required.
Experience with Microsoft office and healthcare database systems required.
Fulfills mandatory stroke education requirements per certification agency
Care Manager Lead (RN)- Registered Nurse (RN) in good standing in the State of California

Nice To Haves

Bilingual or multilingual preferred.
Certification in Utilization Review, Care Management, or Clinical Nursing preferred.
Oncology and Palliative Care: Oncology Social Work Certification (OSW-C) preferred.

Responsibilities

Coordinate patients’ needs through the continuum of care including post-acute care and discharge plans.
Work in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care.
Review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans.
Review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing.
Provide psychodynamic intervention and crisis counseling to support patients and families.
Educate patients and families on their healthcare options and connect them with resources.
Document pertinent patient issues, contacts and discharge plans on the medical records.
Participate in Magnet councils and acts as a preceptor in the Nurse Care Manager intern program
Provide training and clinical supervision to pre-licensed staff as needed.
Provide input to performance evaluations, scheduling, and monitoring workflows.
Responsible for fiscal goals, budget, and productivity.