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

Sharp; Oceanside, Northern (CA, KY); Hybrid; USD 79,000 - 103,000; Full time

Job summary

Sharp Tri-City Medical Center is hiring a Case Manager II to coordinate patient care, discharge planning, and utilization management. The role emphasizes collaboration with the health care team and insurers to optimize outcomes.

Requirements include CA RN licensure with 2+ years in case management; BSN preferred or 5 years' alternative experience; ACM/CCM preferred. On-site, day shift with W/E responsibilities.

Qualifications

• Registered Nurse in CA with active license; BSN preferred.
• 2+ years RN case management or utilization management experience.
• California RN license required; ACM/CCM preferred.

Responsibilities

• Coordinate services to maximize patient outcomes and ensure efficient care delivery.
• Assess, evaluate, and coordinate discharge planning and utilization management.
• Serve as contact person for patient, family, health team, and insurers.
• Document assessments and interactions in the EHR per standards.
• Provide mentorship and participate in quality improvement initiatives.

Skills

Prospective Payment System

Joint Commission standards

Utilization management

Discharge planning

EHR documentation

Payer types knowledge

Referral management

Decision‑making

Prioritization

Verbal & written communication

Education

Bachelor's Degree in Nursing

Associate's Degree in Nursing

CA RN license

Tools

Microsoft Word

EHR systems

Job description

## Case Manager II-Sharp Tri-City - FT - 8hr DaysApply: STCMC Tri-City Medical Center Main Campus - 4002 Vista Way: Full time: Posted Today: JR210382**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 - $75.210This 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.