The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including:
Utilization Management supporting medical necessity and denial prevention
Transition Management promoting appropriate length of stay, readmission preventionandpatientsatisfaction
Care Coordination by demonstrating throughput efficiency while assuring care istherightsequence and at appropriate level ofcare
Compliance with state and federal regulatory requirements, TJC accreditationstandardsandTenetpolicy
Education provided to physicians, patients, families and caregivers
Required Graduate of Accredited School of Nursing BSN preferred
Required at least two (2) years of recent Case Management acute hospital experience or Masters Degree in Case Management;
Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computerliteracy.
Current California Registered Nurses License
Accredited Care Manager (ACM) or Certified Case Manager (CCM) preferred
Internal Number: 1805027759
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