Case Manager

Loma Linda • Murrieta, CA

8h • $68 - $91

About The Position

The Case Manager is a key member of the patient care delivery team, working in a fast-paced environment and applying clinical expertise, discretion, and independent judgment throughout the nursing process—assessment, care planning, intervention, and evaluation—within a patient-centered professional practice model. The role applies specialized case and utilization management methodologies and ensures medical necessity criteria are met and documented for the level of care from admission through discharge.

Working collaboratively with the healthcare team, the Case Manager oversees an interdisciplinary plan of care and develops an individualized, comprehensive discharge plan that best addresses the patient’s continuing healthcare needs. The Case Manager reevaluates the plan as the patient’s needs and condition change, contributes to nursing practice and organizational improvement, and participates in committees, task forces, and staff meetings. Other duties may be assigned as needed.

The position requires a Bachelor of Science in Nursing, at least two years of hospital nursing experience, an active and unrestricted California RN license, and current American Heart Association BLS certification. The employer is a faith- and values-based Christian institution whose mission is to continue the teaching and healing ministry of Jesus Christ; candidates must understand and embrace its mission, purpose, and identity.

Requirements

• Bachelor of Science degree in Nursing (BSN).
• Minimum two years of hospital nursing experience.
• Basic knowledge of case and utilization management practices and methodologies, and state and federal healthcare regulations and accreditation.
• Ability to speak, read, and write legibly in English with professional quality.
• Ability to use a computer, printer, and job-related software, including Microsoft Office Suite, Outlook, an electronic medical record, and an electronic event reporting program.
• Ability to communicate positively and effectively, maintain professional behavior, work calmly under pressure, follow policies assertively and consistently, teach and collaborate, accept direction, think critically, and work independently with minimal supervision.
• Ability to perform basic math and statistical functions; manage multiple assignments; organize and prioritize workload; solve problems; recall information accurately; and pay close attention to detail.
• Sufficient hearing for general in-person and telephone conversation and ability to distinguish workplace sounds; adequate vision to read computer screens, medical records, and written documents.
• Active and unrestricted California Registered Nurse (RN) license.
• Current Basic Life Support (BLS) certification issued by the American Heart Association.
• Understand and embrace Loma Linda and its affiliated entities’ mission, purpose, and identity.

Nice To Haves

• At least two years of case management, utilization review, or discharge planning experience in an acute care environment.
• Spanish language skills.
• Nationally recognized certification in Utilization Management or Case Management.

Responsibilities

• Apply the nursing process—assessment, care planning, intervention, and evaluation—to case management functions within a patient-centered care model.
• Apply case and utilization management methodologies and practices in daily work.
• Ensure medical necessity criteria are met for the level of care provided and documented from admission through discharge.
• Collaborate with the healthcare team to oversee implementation of an interdisciplinary plan of care and a comprehensive, individualized discharge plan.
• Reevaluate the plan of care and confirm its continued appropriateness as patients’ needs and conditions change.
• Support nursing practice and organizational improvement, and participate in committees, task forces, and staff meetings.
• Perform other duties as needed.

What This Job Offers

• Job Type: Full-time