Case Manager Per Diem 10 hr. Shifts

Automatic Data Processing, Inc.; Menifee (CA); Sur place; USD 75 000 - 88 000; Plein temps

Résumé du poste

Menifee Global Medical Center in Menifee, CA seeks a Registered Nurse to coordinate the continuum of care from admission to discharge. You will ensure efficient hospital flow and optimal discharge planning, addressing patient needs and reimbursement considerations.

The role requires an RN license in California and BLS certification, with 2 years’ experience in UM, DC planning, or case management preferred. Collaboration with clinicians and payors is essential to deliver quality care.

Qualifications

• Associate of Science in Nursing required.
• Two years experience in UM, DC planning or case management preferred.
• California RN license required; current BLS certification.
• InterQual guidelines knowledge and reimbursement rules awareness.

Responsabilités

• Coordinate continuum of care from admission through discharge.
• Ensure efficient patient flow and optimal discharge planning.
• Screen post-admission records for quality and reimbursement considerations.
• Collaborate with physicians, payors, and care teams to align on care plans.
• Apply InterQual guidelines and clinical pathways to determine appropriate level of care.

Connaissances

Discharge planning

InterQual guidelines

Crisis intervention

Documentation

Collaboration

Medical terminology

Formation

Associate of Science Degree in Nursing

Description du poste

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Menifee Global Medical Center, Menifee, CA, US

Salary Range: $54.63 To $64.01 Hourly

DEFINITION

Under general direction, coordinates a continuum of care for a selected group of patients from admission through discharge; assures that patients and families proceed efficiently through the course of hospitalization; moves patients through the hospital system in a cost effective manner resulting in the optimal discharge plan; and performs other duties as assigned.

CLASS CHARACTERISTICS

Incumbents in this class are responsible for screening patient post-admission, ongoing review of patient medical records pertaining to the quality of patient care, maximizing reimbursement for services provided and provide optimal discharge planning.

POSITION QUALIFICATIONS

A combination of appropriate education and experience that would likely provide the required knowledge and abilities.

Education

Associate of Science Degree in Nursing

Experience

Two (2) years experience preferred in UM, DC planning, Case Management or equivalent, preferably in an acute hospital setting.

Licensure

Possession of current California RN license required
Current BLS certification

KNOWLEDGE & ABILITIES

• InterQual guidelines
• Payor source documentation requirements and governmental regulations affecting reimbursement.
• Hospital nursing principles, methods, and commonly used medical procedures.
• Common patient disease processes, and the usual methods for treating them.
• Medical terminology, hospital nursing facility routine, and commonly used equipment.
• Identification of potential discharge needs.
• Community resources; hospital nursing facility organization and the interrelationship of various clinical and diagnostic services.

Ability to:

• Evaluate the medical record to assess appropriateness of acute hospitalization as related to intensity of service and severity of illness
• Make recommendations regarding continued stay necessity, appropriateness of the level of the delivery of care.
• Identify discharge needs. Assess available resources and formulate appropriate discharge plan.
• Communicate documentation needs in a manner that promotes cooperation.
• Gather and analyze data and prepare reports and recommendations.
• Work effectively with physicians, other health providers, outside payor sources, community resources, and the general public.
• Relate positively with patients and families; demonstrate crisis intervention skills.
• Collaborates with other nursing personnel, physicians and health care professionals regarding the plan of care.
• Assess patient/family needs for post discharge care. Plans and implements quality, efficient discharge plan, enabling patient to function at their highest level of independence.