RN Case Manager

San Gorgonio Memorial Hospital • Banning, CA

67d • $61

About The Position

The RN Case Manager manages clinical resource utilization and documentation effecting reimbursement. In this position the Case Manager, RN will provide utilization education, identification of inefficiencies in resource utilization, and acting as resource to staff and physicians of San Gorgonio Memorial Hospital in documentation for effective reimbursement. The Case Management RN will be required to consistently demonstrate effective communication skills and the ability to successfully interact with patients and families and to form collaborative relationships with staff, physicians, and outside payors representatives.

Requirements

• ADN / BSN in Nursing; BSN for new hires after Dec. 2017.
• Current CA RN License.
• Minimum of 3 years clinical nursing experience.
• Prefer 1-2 years experience in Utilization Review (U.R.) or Case Management (C.M.).
• Knowledge and experience with Medi-Cal.
• Knowledge and experience with InterQual (CERME) or other national standards.
• Data Entry skills.
• Basic Computer Skills.
• Excellent communication skills and ability to work with others.

Responsibilities

• Manage clinical resource utilization and documentation affecting reimbursement.
• Provide utilization education.
• Identify inefficiencies in resource utilization.
• Act as a resource to staff and physicians in documentation for effective reimbursement.
• Demonstrate effective communication skills.
• Interact successfully with patients and families.
• Form collaborative relationships with staff, physicians, and outside payors representatives.

Benefits

• Medical, dental, vision insurance.
• Basic life and AD&D insurance.
• Optional supplemental life insurance (employee, spouse, and/or child coverage).
• Flexible spending accounts (medical and dependent care).
• 403b retirement with dollar for dollar match up to 5%.
• Paid time off.

What This Job Offers

• Industry: Hospitals
• Education Level: Bachelor's degree