About the position
The Registered Nurse Case Manager functions as a member of the multidisciplinary health care team to facilitate patient movement through the continuum of care and back into the community. The case manager supports the physician and interdisciplinary team in facilitating patient care with the underlying objective of enhancing the quality of the clinical outcomes and patient satisfaction, while managing the cost of care and providing timely and accurate information to payors. As part of the team, the case manager makes decisions regarding utilization management and alternative treatment which reflects cost effectiveness. Provides interface with internal departments and external departments and agencies. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. In addition, the case manager helps drive change by identifying areas where performance improvement is needed. In addition to performing the essential functions listed below, may also be assigned other duties as required.
Responsibilities
- Facilitate patient movement through the continuum of care and back into the community.
- Support the physician and interdisciplinary team in facilitating patient care.
- Enhance the quality of clinical outcomes and patient satisfaction.
- Manage the cost of care and provide timely and accurate information to payors.
- Make decisions regarding utilization management and alternative treatment.
- Interface with internal and external departments and agencies.
- Integrate and coordinate utilization management, care facilitation, and discharge planning functions.
- Identify areas for performance improvement.
Requirements
- California Registered Nurse License and BLS Certification.
- Bachelor of Science in Nursing.
- Two years acute care experience as a Registered Nurse (preferred).
- One-year recent experience in Case Management (preferred).
- Case Management Certification (preferred).
- Current knowledge of reimbursement requirements, level of care, and clinical criteria.
- Basic computer skills.
- Effective interpersonal and communication skills.
- Flexibility to adapt to changing priorities.
- Good customer relations.
- Ability to prioritize assignments and effective time-management skills.
- Detail oriented, flexible, and committed to patient advocacy.
- Skills in planning, organizing, and managing.
- Excellent verbal and written communication skills.
- Knowledge of basic computer software programs.
- Understanding of legal and regulatory issues impacting care delivery and reimbursement process.
Nice-to-haves
- Case Management Certification.
- Two years acute care experience as a Registered Nurse.
- One-year recent experience in Case Management.
Benefits
- Salary Range: $85.87 - $115.94 + applicable differentials
