Case Manager II- Sharp Tri-City - FT - 8hr Days

150 Sharp Tri-City Medical Center; California (MO); On-site; USD 119,000 - 156,000; Full time

Job summary

The Case Manager II coordinates services to maximize patient outcomes, including assessment, discharge planning and collaboration with the health care team. Duties emphasize cost-effective strategies, utilization management, and documentation in the EHR; acts as a patient advocate and liaison for patients, families and insurers.

Requires California RN license and case management experience. Sharp HealthCare provides comprehensive development within a large health system and opportunities to

Qualifications

• Bachelor's/Associate degree with required RN case management experience.
• Minimum 2 years RN experience in case management or utilization management.
• California RN license is required.

Responsibilities

• Coordinate services to maximize patient outcomes with assessment, discharge planning and care coordination.
• Act as contact person and facilitator for patient, family, health care team and claims personnel.
• Document assessments and patient interactions in the EHR.
• Maintain safety, infection control and regulatory compliance.
• Provide preceptorship and mentorship to new graduates and staff.
• Activate emergency response as needed.

Skills

Utilization management

Discharge planning

Joint Commission standards

Prospective Payment System

Payer types

Referral management

Computer skills

Communication

Teamwork

Decision making

Prioritization

Education

Bachelor's Degree in Nursing Or Associate's Degree in Nursing with 5 years’ RN case management experience in lieu of BSN

2 Years experience as a RN in case management or utilization management

California RN license

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.

Sharp HealthCare is a not-for-profit health care system based in San Diego, California, with four acute care hospitals, three specialty hospitals, three medical groups and a health plan. We provide medical services in virtually all fields of medicine, including primary care, heart care, cancer, orthopedics, women’s health, rehabilitation, robotic surgery and bariatric surgery. Sharp sets the community standard for exceptional care. Sharp Grossmont Hospital and Sharp Memorial Hospital have received prestigious Magnet recognition by the American Nurses Credentialing Center for excellence in nursing practices and quality patient care. At the heart of our organization are more than 18,000 affiliated physicians, nurses, staff and volunteers who are on a journey to make health care better for our patients and their families. It’s what we call The Sharp Experience – treating each person with dignity, compassion and respect, and using our clinical excellence and advanced technology to deliver the highest-quality patient care. We are dedicated to transforming the health care experience by making Sharp the best place to work, the best place to practice medicine and the best place to receive care in San Diego.