RN Care Manager, Primary Care Adolescent Clinic

CHOC•Orange, CA

2d•$53 - $87•Onsite

About The Position

The RN Care Manager - Primary Care is responsible for the delivery of care coordination services for specific populations of patients. Provides oversight for the care team which includes the Primary Care Access Coordinator and other members responsible for assisting patients and families with navigating the pediatric system of care. Will formulate and continuously review the plan of care to facilitate the patient's care throughout their care; works collaboratively with the team to ensure care is delivered in an efficient and cost effective manner; promotes efficient use of health care resources; and assumes a leadership role with the care coordination and clinic team to achieve optimal clinical and resource outcomes.

Requirements

Minimum two (2) years of nursing experience in Case Management, or Care Coordination.
Graduation from an accredited school of Registered Nursing; Bachelor of Science degree in Nursing (BSN) (effective on all external offers made after November 1, 2015).
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 and diagnosis.
Strong organizational and time management skills, as evidenced by 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 coordinate care with Primary Care Access Coordinator to obtain authorization for the appropriate treatment setting for patients requiring medical and mental health, 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 Suite e.g., Excel, Word, Power Point, Access etc.
Basic Life Support (BLS)
Registered Nurse – CA (RN)

Nice To Haves

Three (3) years of nursing experience in an/or case management/, - care coordination.
Previous pediatric experience and/or management, and/or charge nurse roll acceptable.
Master’s degree in Nursing or a health-related field from an accredited University.
Certification in Utilization Review and/or Case Management.
Knowledge of CCS/Medi-Cal regulations and requirements.
Knowledge of third-party payor clinical review and authorization requirements.
Ability to apply severity of illness/intensity of service pediatric criteria to information extracted from clinical documentation.
Bilingual in English and Spanish.
Certified Case Manager (CCM), Commission for CM Certification (CCMC).
Certified Pediatric Nurse (CPN).

Responsibilities

Delivery of care coordination services for specific populations of patients.
Oversight for the care team, including the Primary Care Access Coordinator and other members assisting patients and families with navigating the pediatric system of care.
Formulate and continuously review the plan of care to facilitate patient's care.
Collaborate with the team to ensure care is delivered efficiently and cost-effectively.
Promote efficient use of healthcare resources.
Assume a leadership role with the care coordination and clinic team to achieve optimal clinical and resource outcomes.