Case Manager II - Sharp Tri-City - FT - 8hr Day shift

Sharp HealthCare; United States; On-site; USD 79,000 - 103,000; Full time

Benefits offered by this job

CBA with CNA

Job summary

Sharp HealthCare in the United States is seeking a Case Manager II to coordinate services and discharge planning, optimizing patient outcomes while balancing cost efficiency.

The role requires RN licensing in CA, a BSN or ADN with experience, and strong knowledge of payer types, regulatory standards, and evidence-based case management.

Qualifications

• Bachelor’s Degree in Nursing or ADN with 5 years’ RN case management experience.
• California RN license required.
• 2 years RN case management or utilization management experience.
• ACM or CCM certification preferred.

Responsibilities

• Coordinate services to maximize patient outcomes and develop discharge plans.
• Oversee utilization management and discharge planning.
• Collaborate with care team, patients, families, and insurers.
• Document assessments and care activities in the EHR.
• Mentor new grads and support continuing education.

Skills

Prospective Payment System

The Joint Commission standards

Regulatory requirements

Payer types knowledge

Microsoft Word

Referral management system

Rapid decision-making

Prioritization

Communication skills

Education

Bachelor’s Degree in Nursing

Associate’s Degree in Nursing

Tools

Microsoft Word

Job description

Hours:

Shift Start Time:

8:30 AM

Shift End Time:

5 PM

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

As Needed

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$57.000 - $66.110 - $75.210

This position is covered by a Collective Bargaining Agreement (CBA) with CNA.

What You Will Do

The Case Manager II assumes responsibility for the coordination of services in order to maximize patient outcomes. Inherent in the position is assessment, evaluation, collaboration and coordination of patient care delivery systems and participation in appointed service line activities. Emphasis is on cost-effective and cost-efficient strategies which maximize quality care within the current health care environment for the identified patient population. The Case Manager II is responsible for the coordination of utilization management, discharge planning and other health care services/systems. The Case Manager II functions as a contact person, coordinator and facilitator for the patient, family, health care team members and claims/insurance personnel as necessary.

Required Qualifications

• Bachelor’s Degree in Nursing Or
• Associate’s Degree in Nursing with 5 years’ experience as a Registered Nurse in case management in lieu of BSN.
• 2 Years experience as a Registered Nurse in case management or utilization management.
• California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED

Preferred Qualifications

• Accredited Case Manager (ACM) - American Case Management Association (ACMA) -PREFERRED
• Certified Case Manager (CCM) - Commission for Case Manager Certification -PREFERRED

Essential Functions

• The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.
  Maintains a safe, clean working environment, including unit based safety and infection control requirements.
  Patient Care:
  Conduct comprehensive assessments to identify patient needs and develop individualized discharge care plans.
  Responsible for the coordination of services in order to maximize patient outcomes.
  Assess, evaluate, collaborate and coordinate patient care delivery systems and participation in appointed service line activities.
  Responsible for the coordination of utilization management, discharge planning and other health care services/systems.
  Functions as a contact person and facilitator for the patient, family, health care team members and claims/insurance personnel as necessary.
  Act as a patient advocate, ensuring dignity and confidentiality.
  Demonstrate empathy and compassion for patient experience.
  Advocate for evidence-based practices in case management and utilization review.
  Safety and Compliance:
  Maintain a safe, clean working environment, adhering to infection control and hospital policies.
  Comply with regulatory standards (e.g., The Joint Commission, OSHA).
  Identify and report safety concerns proactively.
  Ensures cost-effective and cost-efficient strategies which maximize quality care within the current health care environment for the identified patient populations.
  Documentation:
  Accurately document assessments and patient interactions in the Electronic Health Record (EHR) according to Department Standards.
  Professional Development and Leadership:
  Provide preceptorship and mentorship to New Graduate Nurses, New Hires, and students, supporting their professional development.
  Participate in continuing education and quality improvement initiatives.
  Serve as a resource for best practices within Case Management.
  Emergency Preparedness:
  Activate emergency response system during patient emergencies (e.g., Rapid Response Team (RRT) situations).

Knowledge, Skills, and Abilities

• Knowledge of Prospective Payment System and The Joint Commission standards and regulatory requirements pertaining to Utilization Management and Discharge Planning.
• Proficient computer skills, including Word.
• Knowledge and understanding of various payer types.
• Experience with referral management system.
• Rapid decision-making skills and ability to pivot plans on short notice.
• Ability to prioritize tasks.
• Effective verbal and written communication with the patients, families, and the multidisciplinary team.
• Strong interpersonal skills to support a collaborative team environment.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class