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

Sharp HealthCare; Oceanside (CA); On-site; USD 79,000 - 103,000; Full time

Job summary

Sharp HealthCare in Oceanside is seeking a skilled Case Manager II to coordinate services and maximize patient outcomes. You will assess, evaluate, and collaborate across care teams to ensure efficient utilization management and discharge planning.

The role emphasizes cost-effective strategies while maintaining high quality care, with RN licensure and case management experience required. Excellent communication and teamwork are essential.

Qualifications

• Must hold RN license (CA) and have nursing degree(s).
• Experience in case management and utilization management required.
• Knowledge of payer types and regulatory standards.

Responsibilities

• Coordinate services to maximize patient outcomes and discharge planning.
• Act as liaison between patient, family, health care team, and insurance.
• Document assessments and care plans in the EHR per standards.
• Provide mentorship and participate in quality improvement initiatives.

Skills

Case management

Utilization management

Discharge planning

Regulatory knowledge

EHR documentation

Education

Bachelor's Degree in Nursing

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

Tools

Word

Referral management system

Job description

Hours and Compensation

Shift start time: 8:30 AM. Shift end time: 5 PM. AWS hours requirement: 8/40 - 8 Hour Shift. 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