Case Manager

Loma Linda • Loma Linda, CA

4d • $59 - $80 • Onsite

About The Position

The Case Manager serves as a key member of the patient care delivery team at a Magnet Recognized, large tertiary academic medical center with Level I trauma designation, STEMI receiving center designation, and Comprehensive Stroke Center and Chest Pain Center accreditation. The role applies clinical expertise and independent judgment to the nursing process—assessment, care planning, intervention, and evaluation—in a patient-centered professional practice model, as it relates to case management functions.

The Case Manager applies case and utilization management methodologies to ensure medical necessity criteria are met and documented from admission through discharge. In collaboration with the health care team, the role oversees an interdisciplinary plan of care and an individualized discharge plan that addresses the patient's continuing health care needs. The plan is reevaluated as the patient's condition and needs change.

The position functions within professional nursing expectations and nursing excellence standards, supporting the achievement and maintenance of Magnet Recognition. The Case Manager embraces new knowledge and improvements, helps implement change, and participates in opportunities to influence bedside clinical practice through governance councils, committees, taskforces, and staff meetings. Other duties may be assigned as needed.

The position is full-time and onsite, Monday through Friday, 8:00 a.m. to 4:30 p.m., on five eight-hour shifts. Weekend or holiday work may be required based on operational needs. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities, a Seventh-day Adventist faith- and values-based Christian institution.

Requirements

• Bachelor of Science degree in Nursing (BSN).
• At least two years of hospital nursing experience.
• Basic knowledge of case and utilization management practices and methodologies, and state and federal health care regulations and accreditation.
• Active and unrestricted California Registered Nurse (RN) license.
• Current Basic Life Support (BLS) certification issued by the American Heart Association.
• Ability to speak, read, and write legibly in English with professional quality.
• Ability to use a computer, printer, and position-related software, including Microsoft Office Suite, Outlook, an electronic medical record, and an electronic event reporting program.
• Ability to communicate and relate positively and effectively, maintain professional behavior, remain calm and courteous under pressure, follow policies 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; problem solve; recall information accurately; and attend closely to detail.
• Sufficient hearing for conversation in person and by telephone, ability to distinguish workplace sounds, and adequate vision to read computer screens, medical records, and written documents.
• Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities.

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.
• Apply specialized 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 health care team to oversee implementation of an interdisciplinary plan of care and a comprehensive, individualized discharge plan.
• Reevaluate the plan of care and ensure it remains appropriate as the patient's needs and condition change.
• Meet professional nursing and nursing excellence standards in support of Magnet Recognition.
• Embrace new knowledge, innovations, and improvements; act as a change agent and help minimize resistance to change.
• Participate in professional governance councils, committees, taskforces, and staff meetings to influence bedside clinical practice.
• Perform other duties as needed.

What This Job Offers

• Job Type: Full-time