Job Description

What You Will Do in This Role:

A Registered Nurse Case Manager plans and coordinates care of the patient from pre-hospitalization through discharge. Works with all members of the health care team to ensure a collaborative approach is maintained in care and treatment of the patient. Reviews care and treatment for appropriateness against screening criteria and for infection control, quality services for continued stay and through discharge. Plans and coordinates home care services and needs. Coordinates the discharge planning function in conjunction with the social worker. Participates in education on and implementation of clinical guidelines and protocols. Provides or arranges patient teaching as appropriate. Works closely with social workers to integrate psychosocial management of patient/family needs.

Primary Duties and Responsibilities:

• Performs evaluation and or assessment within the established/communicated timeframe
• Documents appropriate reviews for assigned patients using utilization review tool.
• Provides telephonic review for identified contracted/private patients collaborates with on-site and/or outside reviewers.
• Keeps patients informed of progress and provides information related to disease progression.
• Collaborates with discharge planner to make orders and arranges for home care equipment, healthcare needs, and works with third-party payers to validate orders.
• Educates patients and families on all aspects of patients’ hospitalization and continuing care.
• Assumes responsibility for timely completion of required case management reports for regulatory bodies, health plans, and insurance carriers.
• Interacts professionally with patient/family/caregivers and involves them in the formation of the plan of care and discharge needs.
• Coordinates with multidisciplinary team to ensure the identification of a safe and appropriate discharge plan for each assigned patient.
• Documentation meets current standards and policies.
• Maintains department cleanliness and safety.

Shift: 8:00AM - 4:30PM, Monday - Friday, ONSITE

Qualifications

Education:

• Associate's degree in Nursing (required).
• Bachelor's degree in Nursing (preferred).

Certifications/Licenses:

• Current and valid California RN License (required).
• Certified Case Manager (CCM) or Accredited Case Manager (ACM) (preferred).

Experience:

• Minimum of 2 years of nursing experience in an acute care setting (required).
• Minimum of 1year of Case Management experience (preferred).
• Experience with Utilization Review (strongly preferred).