Job Description

This role is Monday-Friday, 8am-5pm but may require weekends and holidays to meet operational needs.

The Manager-Case Management works collaboratively with the Director and Assistant Vice President (AVP) � Care Coordination to provide direction and management of the day-to-day functions of case management services across three hospital sites licensed under Loma Linda University Medical Center (LLUMC) serving both inpatients and outpatients in an academic medical center with Level One Trauma designation, Comprehensive Stroke Center Certification and ST-Elevation Myocardial Infarction (STEMI) Receiving Center designation. Participates in developing, implementing, and maintaining a fiscally sound case management program and ensures cohesive patient-centered care practices which address the needs of the patients from admission through discharge and across the continuum of care. Participates in overseeing case management onsite reviewers from payer insurances/organizations. Maintains a positive working relationship with payers and keeps each payer informed of changes during in-patient stay, discharge plan, and resources needed for safe and timely discharge. Performs other duties as needed.

Education and Experience: Bachelor of Science Degree in Nursing required. Master's degree in healthcare or finance related field preferred. Minimum two years nursing experience which has provided opportunity to demonstrate competencies in case management, clinical nursing, leadership, administration, or education required.

Knowledge and Skills: Substantial knowledge of case management practice, state and federal healthcare regulations, third party payers, finance, performance improvement, quality, patient safety, evidenced-based clinical practice standards, medical staff structure and legal aspects of care required. Knowledge of adult learning principles, management and problem-solving methodologies. Exhibits professional behavior at all times. Able to speak, read and write legibly in English (and Spanish preferred) with professional quality; use computer, printer, and software programs necessary to the position, e.g., Word, Excel, Outlook, PowerPoint, electronic medical record, electronic event reporting program; relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction; think critically; use sound judgment based on factual information and clinical knowledge; work independently with minimal supervision; meet deadlines; perform basic math and statistical functions; manage multiple assignments effectively; organize and prioritize workload; problem solve in a proactive and creative manner; recall information with accuracy; pay close attention to detail; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position.

Licensures and Certifications: Active California Registered Nurse Licensure required. Basic Life Support Certification from the American Heart Association required. Valid California Driver's License and automobile insurance required. Case Management Certification preferred.

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.