RN Care Manager (Per Diem)

CHOC•Commerce Tower, FL

1d•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. This Per Diem RN Care Manager role is a great opportunity for someone interested in gaining exposure across the continuum of care, including Inpatient, Outpatient and/or Emergency Department settings. Ideally, we are looking for someone with a flexible schedule, as we have coverage needs that can include weekends, week days, and evenings. The RN Care Manager is responsible for one of the following: the delivery of care coordination services for patients admitted to an inpatient bed, in the specialty clinics, or performing utilization review of all inpatient services.

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
Assume a leadership role for the primary role assigned to the interdisciplinary team to achieve optimal clinical and resource outcomes
Provide 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