Registered Nurse Case Manager (RN)

Tenet Healthcare Corporation • Palm Springs, CA

5d

About The Position

The individual in this position has overall responsibility for overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements. This position integrates care coordination, utilization management, and discharge planning.
The individual’s responsibilities will include, but not be limited to the following activities: a) medical necessity screening b) care coordination c) discharge planning d) facilitating multi-disciplinary patient care conferences e) managing concurrent disputes f) making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST) g ) referring complex social issues to Social Service h ) communicating with patients and their families about the plan of care i) collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy) j) participating in weekly Complex Case Review k) arranging for post –discharge patient education l) clear, complete and concise documentation in eCCM m ) maintaining accuracy of patient demographic and insurance information n) identifying and documenting potentially avoidable days o) identifying and reporting over and under utilization o) and other duties as assigned.
Attends hospital workshop led by the Director of Case Management or designee that includes the Tenet Case Management Model, InterQual, Discharge Planning, Utilization Management, and other topics specific to case management. Extended orientation with selected Case Managers may occur.
Information used to perform job: patient data, healthcare staff documentation related to patient care, regulatory and payor requirements
Software used to perform job: eCCM: Clinical data interface, InterQual, Case Management documentation, secure faxing, Avoidable Day tracking, Patient Medical Record and HPF, Hospital specific Clinical Software

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Desert Regional Medical Center hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.
At Desert Regional Medical Center, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
Medical, dental, vision, and life insurance
401(k) retirement savings plan with employer match
Generous paid time off
Career development and continuing education opportunities
Health savings accounts, healthcare & dependent flexible spending accounts
Employee Assistance program, Employee discount program
Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance
Note: Eligibility for benefits may vary by location and is determined by employment status

Desert Care Network serves the healthcare needs of the Coachella Valley and Morongo Basin regions in Southern California with three hospitals Desert Regional Medical Center in Palm Springs, JFK Memorial Hospital in Indio and Hi-Desert Medical Center in Joshua Tree. The hospital network provides advanced care with services such as comprehensive stroke care, a cancer center, a Level 1 Trauma Center and the only Level 3 Neonatal Intensive Care Unit (NICU) in the Coachella Valley. Desert Care Network is committed to healthcare equality. Join our team!

Responsibilities

• overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements
• integrates care coordination, utilization management, and discharge planning
• medical necessity screening
• care coordination
• discharge planning
• facilitating multi-disciplinary patient care conferences
• managing concurrent disputes
• making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST)
• referring complex social issues to Social Service
• communicating with patients and their families about the plan of care
• collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy)
• participating in weekly Complex Case Review
• arranging for post –discharge patient education
• clear, complete and concise documentation in eCCM
• maintaining accuracy of patient demographic and insurance information
• identifying and documenting potentially avoidable days
• identifying and reporting over and under utilization
• other duties as assigned

Benefits

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed