Case Manager, RN - Pre Access

HENRY MAYO NEWHALL MEMORIAL HOSPITAL • Santa Clarita, CA

2d • Onsite

About The Position

The RN Case Manager-Pre Access is responsible for screening, coordinating, and facilitating admission review of all acute patients. Working collaboratively with all interdisciplinary staff, facilitates admission and transfer of patients, ensure that each patient is admitted meeting established medical guidelines in collaboration with credentialed medical staff, assist with the coordination of patient transfers into the hospital, and communicates all requested and questionable admissions/transfers to the Director of Case Management , and/or Physician Advisor.

Requirements

• Current CA RN license
• Current BLS provider card
• Diploma, AA, BS in Nursing
• Two (2) years as a Case Manager in an acute care setting or five years recent acute care nursing experience preferred.
• Demonstrates strong interpersonal skills, leadership ability, negotiation skills, and knowledge of hospital operations.
• General knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential.
• Knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential
• Knowledge of State and Federal regulations; e.g. EMTALA, Medi-Cal, HMOs, etc.
• Understanding of Medicare, Medi-Cal and other Third Party Payer regulations
• Understanding of current utilization/quality management principles, techniques and procedures
• Advanced experience utilizing InterQual required.

Nice To Haves

• Case Management certification preferred
• MS in Nursing preferred
• Experience in Critical Care setting preferred

Responsibilities

• Screening, coordinating, and facilitating admission review of all acute patients.
• Facilitating admission and transfer of patients in collaboration with interdisciplinary staff.
• Ensuring patients are admitted meeting established medical guidelines in collaboration with credentialed medical staff.
• Assisting with the coordination of patient transfers into the hospital.
• Communicating all requested and questionable admissions/transfers to the Director of Case Management and/or Physician Advisor.
• Developing, maintaining, and modeling professional, objective and value-oriented interpersonal skills.
• Continuously promoting a patient-centered philosophy.
• Maintaining positive and proactive communication with patients, families, staff members, and physicians.
• Fostering team-building relationships.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree