Registered Nurse Case Manager - Case Management - Per Diem - 10-hour shifts - Days

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

Job summary

Washington Health in Fremont, CA seeks a Registered Nurse Case Manager to coordinate patient care across the continuum, support the physician and interdisciplinary team, and promote high-quality outcomes while managing care costs.

The role interfaces with internal and external departments, drives performance improvement, and participates in utilization management and discharge planning to ensure timely, accurate information for payors.

Qualifications

• California RN license and BLS certification.
• BSN required.
• Two years acute care experience preferred.
• One year case management experience preferred.
• Case Management Certification preferred.
• Understanding of reimbursement requirements and CMS criteria.
• Excellent verbal and written communication skills.

Responsibilities

• Facilitate patient movement through the continuum of care.
• Coordinate utilization management, care facilitation and discharge planning.
• Interface with internal and external departments and agencies.
• Identify areas for performance improvement and drive change.

Skills

Interpersonal skills

Communication skills

Time management

Planning and organizing

Detail oriented

Customer relations

Adaptability

Education

Bachelor of Science in Nursing

Tools

EHR familiarity

Basic computer software

Job description

Salary Range: $90.16 - $121.74 + applicable differentials

The Registered Nurse Case Manager functions as a member of the multidisciplinary health care team to facilitate patient movement through the continuum of care and back into the community. The case manager supports the physician and interdisciplinary team in facilitation of patient care with the underlying iining objective of enhancing the quality of the clinical outcomes and patient satisfaction, while managing the cost of care and providing timely and accurate informa to payors. As part of the team, the case manager makes decisions regarding utilization management and a alternative treatment which reflects cost effectiveness. Prodives interface with internal departments and externa ldepartments an and agencies. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. In addition, the case manager helps drive change by identifying areas where performance improvement is needed. In addition to performing the essential functions listed below, may also be assigned other duties 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.