Case Manager, Registered Nurse

Sutter Health • San Francisco, CA

5d • $83 - $112

About The Position

We are so glad you are interested in joining Sutter Health! Organization: CPMC-California Pacific Med Center Van Ness Position Overview: Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation. Oversees the management of acute patient populations across the care continuum with a focus to provide coordinated and integrated care to prevent unnecessary admissions or readmissions. Provides discharge planning coordination and Intervention for the high risk patient presenting to the Emergency Department. Strives to promote patient wellness, improved care outcomes, efficient utilization of health services and minimized denials of payment among a patient population with complex health needs. Job Description: EDUCATION: Other: Graduate of an accredited school of nursing Bachelor's: BS in one of following: Nursing or Health Administration preferred. Master's: Master in nursing, case management or related field preferred. CERTIFICATION & LICENSURE: RN-Registered Nurse of California CCM - Certified Case Manager (Preferred) TYPICAL EXPERIENCE: 2 years recent relevant experience SKILLS AND KNOWLEDGE: A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of care, and observation status. Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Title 22, CHA Consent Manual, California Department of Public Health (CDPH) and The Joint Commission (TJC). A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements. Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. Demonstrates commitment to service excellence in all patient, family and employee interactions and in performing all job responsibilities. Functions in a manner to promote quality patient care and assure a positive patient experience. Verbal and written communication skills. Interpersonal communication and negotiation skills. Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. Intermediate computer skills. Ability to promote teamwork and to effectively function in teams. Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. Job Shift: Days Schedule: Part Time Shift Hours: 8 Days of the Week: Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: Yes Position Status: Non-Exempt Weekly Hours: 36 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $82.84 to $112.10 / hour The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package. Working at Sutter Health Sutter Health values and supports the unique talents and strengths that each employee brings to our organization. As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.

Requirements

• Graduate of an accredited school of nursing
• RN-Registered Nurse of California
• 2 years recent relevant experience
• A broad knowledge base of health care delivery and case management within a managed care environment.
• Comprehensive knowledge of Utilization Review, levels of care, and observation status.
• Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Title 22, CHA Consent Manual, California Department of Public Health (CDPH) and The Joint Commission (TJC).
• A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements.
• Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners.
• Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
• Demonstrates commitment to service excellence in all patient, family and employee interactions and in performing all job responsibilities.
• Functions in a manner to promote quality patient care and assure a positive patient experience.
• Verbal and written communication skills.
• Interpersonal communication and negotiation skills.
• Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
• Intermediate computer skills.
• Ability to promote teamwork and to effectively function in teams.
• Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience.

Nice To Haves

• BS in one of following: Nursing or Health Administration preferred.
• Master's: Master in nursing, case management or related field preferred.
• CCM - Certified Case Manager (Preferred)

Responsibilities

• Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation.
• Oversees the management of acute patient populations across the care continuum with a focus to provide coordinated and integrated care to prevent unnecessary admissions or readmissions.
• Provides discharge planning coordination and Intervention for the high risk patient presenting to the Emergency Department.
• Strives to promote patient wellness, improved care outcomes, efficient utilization of health services and minimized denials of payment among a patient population with complex health needs.

Benefits

• Sutter Health values and supports the unique talents and strengths that each employee brings to our organization.
• As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level