RN Care Manager, Nephrology

CHOC•Orange, CA

1d•$53 - $87•Onsite

About The Position

The RN Care Manager is responsible for delivering care coordination services for patients in the clinic setting. The role participates in planning and delivering family-centered patient care through a collaborative process involving the patient and family, nurses, social workers, physicians, other practitioners, caregivers, and the community. The RN Care Manager communicates effectively, facilitates care across the continuum, advocates for patients, and helps them achieve optimal health and access appropriate resources. The role provides a full range of nursing care and helps meet the comprehensive care needs of patients and their families. The position is eligible to be paneled by CCS to provide collaborative, comprehensive care in a multidisciplinary setting.

Requirements

At least two years of nursing experience in pediatric care or an ambulatory setting.
Bachelor of Science in Nursing from an accredited university.
Basic Life Support (BLS) certification.
Registered Nurse license in California (RN).
Ability to work effectively under pressure amid changing priorities, interruptions, census fluctuations, payer demands, and discharge-planning demands.
Excellent interpersonal communication, conflict resolution, problem-solving, and negotiation skills.
Clinical knowledge of multiple age groups, medical illnesses, and treatment plans in relation to disease processes, diagnoses, and anticipated length of stay.
Strong organizational and time-management skills, including the ability to multitask and prioritize.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, patients, and families.
Ability to communicate with third-party payers to obtain authorization for appropriate treatment settings for patients requiring medical, psychiatric, or chemical-dependency treatment.
Must demonstrate required competencies upon completion of orientation and maintain annual departmental competency requirements.
Ability to collaborate effectively across social, economic, and cultural backgrounds.
Computer skills, including Microsoft Office applications such as Excel, Word, PowerPoint, and Access.

Nice To Haves

Three or more years of nursing experience in an emergency department and/or case management, care coordination, or transition of care.
Previous pediatric experience and/or management experience; charge nurse experience is also acceptable.
Master's Degree in Nursing from an accredited university.
Certification in Case Management.
Knowledge of CCS/Medi-Cal regulations and requirements.
Knowledge of third-party payer requirements to optimize reimbursement.
Ability to apply pediatric severity-of-illness and intensity-of-service criteria to information extracted from clinical documentation.
Bilingual ability.
Certified Pediatric Nurse (CPN).
Certified Case Manager (CCM) or Commission for Case Manager Certification (CCMC) certification.
Pediatric Advanced Life Support (PALS) certification.

Responsibilities

Deliver care coordination services to patients in the clinic setting.
Participate in planning and delivering family-centered patient care in collaboration with patients, families, clinical teams, caregivers, and the community.
Communicate effectively and facilitate care along the continuum.
Advocate for patients and assist them in achieving optimal health and accessing appropriate resources.
Provide nursing care and help meet the comprehensive care needs of patients and their families.