Registered Nurse, Care Manager (Per Diem)

Children's Hospital of Orange County • Orange, CA

2d • Onsite

About The Position

The RN Care Manager is responsible for one of the following: utilization review of all inpatient services; the delivery of care coordination services for patients admitted to an inpatient bed or in the specialty clinics. Assumes a leadership role for the primary role assigned to the interdisciplinary team to achieve optimal clinical and resource outcomes. Provides oversight for care teams which includes the care manager assistant and other members responsible for assisting patients and families with navigating the pediatric system of care. Is involved in the planning and delivery of patient and family-centered care through a collaborative process including the patient and family, nurses, social workers, physicians, other practitioners, caregivers, and the community. Also responsible for securing authorizations and promoting the efficient use of healthcare resources. Provides a full range of nursing care and assists in meeting the comprehensive care needs of the patients and their families.

Requirements

• Minimum two (2) years of nursing experience in a pediatric care or ambulatory setting
• Graduation with a bachelor’s degree from an accredited University
• Ability to work effectively under pressure due to changing priorities, interruptions, high/low census, payor demands and discharge planning demands
• Excellent interpersonal communication, including conflict resolution, problem-solving, and negotiation skills
• Clinical knowledge of multiple age groups, medical illness, and treatment plans according to disease process, diagnosis and anticipated LOS
• Strong organizational and time management skills, as evidenced by the capacity to multi-task and prioritize
• Ability to work independently and exercise sound judgment in interactions with physicians, payers, patients, and their families
• Demonstrates the knowledge and skills necessary to communicate with third-party payers to obtain authorization for the appropriate treatment setting for patients requiring medical, psych and chemical dependency treatment
• Must be proficient in required competencies upon completion of orientation and maintain annual departmental competency requirements
• Ability to work collaboratively regardless of social, economic, and cultural backgrounds
• Computer knowledge to include skills in using Microsoft Office e.g., Excel, Word, PowerPoint, Access, etc.
• Registered Nurse (RN) – CA
• Basic Life Support (BLS)

Nice To Haves

• Three (3) years of nursing experience in an emergency department and/or case management, care coordination, or transition of care
• Previous pediatric experience and/or management and/or charge nurse role acceptable
• Bachelor or master’s degree in Nursing or a health-related field from an accredited University
• Certification in Case Management
• Knowledge of CCS/Medi-Cal regulations and requirements
• Knowledge of third-party payor requirements in order to optimize reimbursement
• Ability to apply severity of illness/ intensity of service pediatric criteria to information extracted from clinical documentation
• Bilingual in English and Spanish
• Certified Pediatric Nurse (CPN)
• Certified Case Manager (CCM)
• Commission for Case Manager Certification (CCMC)
• Valid Pediatric Advanced Life Support (PALS)

Responsibilities

• Utilization review of all inpatient services
• Delivery of care coordination services for patients admitted to an inpatient bed or in the specialty clinics
• Assumes a leadership role for the primary role assigned to the interdisciplinary team to achieve optimal clinical and resource outcomes
• Provides oversight for care teams which includes the care manager assistant and other members responsible for assisting patients and families with navigating the pediatric system of care
• Involved in the planning and delivery of patient and family-centered care through a collaborative process including the patient and family, nurses, social workers, physicians, other practitioners, caregivers, and the community
• Securing authorizations and promoting the efficient use of healthcare resources
• Provides a full range of nursing care and assists in meeting the comprehensive care needs of the patients and their families

Benefits

• CHOC’s compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals.

What This Job Offers

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