Case Manager

Tri-City Medical Center•Oceanside, CA

20h•Onsite

About The Position

Tri-City Medical Center has served San Diego County’s coastal communities of Carlsbad, Oceanside and Vista, as well as the surrounding region for more than 60 years and is one of the largest employers in North San Diego County. Tri-City is administered by the Tri-City Healthcare District, a California Hospital District. As a full-service acute care public hospital with over 500 physicians practicing in over 60 specialties, Tri-City is vital to the well-being of our community and serves as a healthcare safety net for many of our citizens. The hospital has received a Gold Seal of Approval® from the Joint Commission showcasing a commitment to safe and effective patient care for the residents of the community. Tri-City Medical Center prides itself on being the home to leading orthopedic, spine and cardiovascular health services while also specializing in world-class robotic surgery, cancer and emergency care. Tri-City’s Emergency Department is there for your loved ones in their time of need and is highly regarded for our heart attack and stroke treatment programs. When minutes matter Tri-City is your source for quality compassionate care close to home. Tri-City partners with over 90 local non-profit and community organizations as part of our COASTAL Commitment initiative. Together we are helping tackle some of our communities’ pressing health and social needs. Position Summary : The Case Manager assumes responsibility for the coordination of services in order to maximize patient outcomes. Inherent in the position is assessment, evaluation, collaboration and coordination of patient care delivery systems and participation in appointed service line activities. Emphasis is on cost-effective and cost-efficient strategies which maximize quality care within the current health care environment for the identified patient population. The Case Manager I is responsible for the coordination of utilization management, discharge planning and other health care services/systems. The Case Manager I functions as a contact person, coordinator and facilitator for the patient, family, health care team members, and claims/insurance personnel as necessary.

Requirements

Current California Registered Nurse, required.
Associate Degree, Nursing (ADN), required
Proficient computer skills, including Word.
Effective verbal and written communication with the patients, families, and the multidisciplinary team.
Strong interpersonal skills to support a collaborative team environment.
Experienced Case Manager RN: Six (6) months of experience as a Registered Nurse in Case Management or Utilization Management, required.
Transitional RN Program: Two (2) years of experience as a Registered Nurse in an acute care setting, required

Nice To Haves

Bachelor of Science in Nursing (BSN), preferred.
Knowledge of Prospective Payment System and Joint Commission standards and regulatory requirements pertaining to Utilization Management and Discharge Planning preferred.
Experience with referral management system, preferred
Rapid decision-making skills and ability to pivot plans on short notice
Ability to prioritize tasks

Responsibilities

Conduct comprehensive assessments to identify patient needs and develop individualized discharge care plans.
Responsible for the coordination of services in order to maximize patient outcomes.
Assess, evaluate, collaborate and coordinate patient care delivery systems and participation in appointed service line activities.
Responsible for the coordination of utilization management, discharge planning and other health care services/systems.
Functions as a contact person and facilitator for the patient, family, health care team members and claims/insurance personnel as necessary.
Act as a patient advocate, ensuring dignity and confidently.
Demonstrate empathy and compassion for patient experience.
Advocate for evidence-based practices in case management and utilization review.
Maintain a safe, clean working environment, adhering to infection control and hospital policies.
Comply with regulatory standards (e.g., The Joint Commission, OSHA).
Identify and report safety concerns proactivitely.
Ensures cost-effective and cost-efficient strategies which maximize quality care within the current health care environment for the identified patient populations.
Accurately document assessments and patient interactions in the Electronic Health Record (EHR) according to Department Standards
Provide mentorship to New Grad staff and students, supporting their professional development.
Participate in continuing education and quality improvement initatives.
Activate emergency response system during patient emergencies (e.g., Rapid Response Team (RRT) situations).