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CASE MANAGER RN - HOAG CLINIC
Costa Mesa, CA The Case Manager (RN) utilizes clinical expertise, discretion, and independent judgment to case management and care coordination methodologies and practices, focusing on the needs of **MEMBERS ONLY**SIGN UP NOW*** Hospital and its affiliates (the "Organization") patient population in partnership with the Organization's physicians, staff, and inpatient providers. The Case Manager (RN) displays and practices a work-style reflecting the mission, vision and values of the Case Management team, as well as the Organization. Participates in the continuous quality improvement process. Maintains a working knowledge of departmental standard operating procedures, including the use of specialized instrumentation, Quality Control requirements, and preventive maintenance. Essential Functions Case Manager RN (I): • Comprehensively plans for care management services for patients and their families. • Carries out activities related to utilization management, determination of post acute clinical care needs (discharge planning) and level of care, care coordination and referral to other levels of care. • Works with interdisciplinary team to facilitate clinical pathways and achievement of desired treatment outcomes. • Works collaboratively to ensure patient needs are met and care delivery is coordinated. Case Manager (RN) II: • Collaborates with the Social Worker in the development of a plan for post acute needs identified in the interdisciplinary Meetings. • In-depth knowledge of payor source implications for the discharge plan, resources and placement options to maximize a patient's successful discharge. • Chairs and disseminates necessary clinical and social information to all members of the Interdisciplinary team. • Utilizes an interdisciplinary process to assess, plan, and provide patient care for specific diagnoses from admission through after care. • Coordinates and monitors progress toward established discharge goals in a weekly meeting of the Interdisciplinary Team to achieve a smooth transition from admission to discharge. • Promotes appropriate post-hospital utilization of resources, adequate education of patient and Organization staff, and decreased incidence of re-admission. • Acts as a resource for patients and staff providing updates on care and options available for discharge. Attends educational meetings to keep current in field. Case Manager Lead (RN): • Provide individual and group supervision for the Case Manager (RN) team. • Monitors Case Manager (RN) patient load for capacity and acuity. • Monitors and ensures complaints are prioritized and resolved in a timely fashion with appropriate documentation and follow-up as required. • Identifies areas for improvement and implements improved workflow processes, responding to departmental needs in a timely fashion with minimal impact to patients and Organization staff. • Drives performance improvement initiatives related to Case Management, including identification of new concepts and processes to reduce patient delays. • Creates a climate in which people want to work to do their best; inspires and motivates employees to achieve the Organization's goals; motivates many types of direct reports, teams, or project members; assesses individual motivation and uses knowledge to maximize employee's contributions. • Establishes clear responsibilities and expectations for employees, set goals, hold employees accountable and provides proper coaching and developing. • Performs other duties as assigned Education, Training and Experience Required: Case Manager (RN) I: • Current license to practice as a Registered Nurse (RN) within the State of California. • Current American Heart Association Healthcare Provider BLS (CPR) certification. Case Manager (RN) II: In addition to the above, the Case Manager (RN) II will have: • Bachelors or Masters degree in nursing (BSN, MSN) or social work (BSW, MSW). • Minimum five (5) years of clinical experience in acute healthcare system environment • Minimum one (1) year of discharge planning or utilization review in an acute healthcare system environment. • Knowledge/expertise in Interqual or Millennium Guidelines. Case Manager Lead (RN): • Minimum of one (1) years supervisory experience, preferably within Case Management at an acute healthcare system environment, or equivalent combination of education and work experience. Preferred: • Certification in Utilization Review, Care Management, or Clinical Nursing area certification. Skills or Other Qualifications Required: • Self-directed individual with ability to prioritize multiple tasks and meet deadlines, excellent attention to detail, and maintain a high level of work quality. • Strong team player with excellent oral, verbal and presentation communication skills. • Proven ability to interface with all customer levels (physicians, Organizational staff, insurance companies, patients and family members). • Working knowledge of Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint, plus healthcare database systems. • Decisive and capable of exercising good judgment under pressure. Preferred: • Qualified bilingual or multilingual candidates. License and Certifications Required: Case Manager (RN) I, II, Lead: • Current license to practice as a Registered Nurse (RN) within the State of California. • Current American Heart Association Healthcare Provider BLS (CPR) certification. Preferred |
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