Registered Nurse Case Manager - Case Management - Full Time - 10-hour shifts - Days

Washington Hospital; Fremont (CA); On-site; USD 124,000 - 168,000; Full time

Job summary

Washington Hospital in Fremont, CA is seeking a Registered Nurse Case Manager to coordinate patient movement through the continuum of care and back into the community, supporting the physician and interdisciplinary team to optimize clinical outcomes and patient satisfaction while managing costs.

The role involves utilization management, discharge planning, and interfacing with internal and external departments; contributes to performance improvement and may take on other duties as needed.

Qualifications

• California Registered Nurse License and BLS Certification.
• Bachelor of Science in Nursing, required.
• Two years acute care experience as a Registered Nurse, preferred.
• One-year recent experience in Case Management, preferred.
• Case Management Certification, preferred.
• Current knowledge of reimbursement requirements, level of care, and clinical criteria.
• Basic computer skills required.
• Demonstrates effective interpersonal and communication skills.
• Demonstrates flexibility via an ability to adapt to changing priorities.
• Demonstrates good customer relations.
• Ability to prioritize assignments and effective time-management skills.
• Must be detail oriented, flexible, and committed to patient advocacy.
• Demonstrates skills in planning, organizing, and managing.
• Excellent verbal and written communication skills required.
• Knowledge of basic computer software programs.

Responsibilities

• Facilitates patient movement through the continuum of care and back into the community.
• Supports the physician and interdisciplinary team in patient care.
• Provides interface with internal and external departments and agencies.
• Coordinates utilization management, care facilitation and discharge planning functions.
• Identifies areas where performance improvement is needed.
• May be assigned other duties as required.

Job description

Salary Range: $90.16 - $121.74 + applicable differentials

The Registered Nurse Case Manager funct i ons as a membe r of t h e m ul t i discipl i nary health care team to facilitate patient movement through the continuum of care and back into the community. The case manager supports the physician and i nterdisciplinary team in facilitat i ng patient care with t he under l y i ng objective of enhancing the quality of the clin i ca l outcomes and pat i ent satisfaction, wh il e managing the cost of care and providing timely and accurate informa t i on to payors. As part of the team, the case manager makes decisions regarding utilization managemen t and a l alternative t r e a tment which reflects cost effect i ve n ess. Prov i des interface with internal departments an d externa l departments a n d agenc i es. The ro l e integrates and coordinates uti lization management, care facilitation and discharge planning funct i ons.In addition , the case manager helps d r ive c h an ge by identifying areas where performance improvement i s n e eded.In addition to performing t h e ess entia l funct ions listed below , may also be ass i gned other dut i es as required.

Qualifications:

• California Registered Nurse License and BLS Certification.
• Bachelor of Science in Nursing, required.
• Two years acute care experience as a Registered Nurse, preferred.
• One-year recent experience in Case Management, preferred.
• Case Management Certification, preferred.
• Current knowledge of reimbursement requirements, level of care, and clinical criteria.
• Basic computer skills required.
• Demonstrates effective interpersonal and communication skills.
• Demonstrates flexibility via an ability to adapt to changing priorities.
• Demonstrates good customer relations.
• Ability to prioritize assignments and effective time-management skills.
• Must be detail oriented, flexible, and committed to patient advocacy.
• Demonstrates skills in planning, organizing, and managing.
• Excellent verbal and written communication skills required.
• Knowledge of basic computer software programs.

Regulatory/Compliance:

• Demonstrates an understanding of legal and regulatory issues (i/e., HIPPA, EMTALA, The Joint Commission, Centers for Medicare and Medicaid Services (CMS) impacting the care delivery and reimbursement process.
• Demonstrates understanding of the CMS Conditions of Participation
• Practices within the scope of the California Nurse Practice Act (Section 2725) in all aspects of patient care, promoting safe practice in order to reduce risk.
• Adheres to hospital, divisional and unit-based policies and procedures.