Registered Nurse (RN) - Case Manager

Huntington Beach Hospital; Huntington Beach (CA); On-site; USD 133,299,000 - 179,235,000; Part time

Job summary

Huntington Beach Hospital seeks an experienced nurse leader to oversee admissions, case management, and care coordination. You will ensure quality outcomes, appropriate utilization, and seamless patient flow from admission through discharge, working to optimize resources and promote cost containment.

Applicants should have a registered nurse license, extensive acute care nursing experience, and familiarity with care-management processes; social work licensure is a plus.

Qualifications

• RN license and nursing degree required or equivalent.
• Minimum 5 years of nursing experience after graduation.
• Experience in case management or discharge planning preferred.
• BCLS certification preferred; knowledge of utilization criteria beneficial.

Responsibilities

• Oversee quality and resource management for admitted patients.
• Promote cost containment and coordinate care across providers.
• Lead admission and concurrent review for medical necessity and intensity of service.

Skills

Case management experience

Computer literacy

Discharge planning experience

BCLS certification

Education

RN license with nursing degree

5 years nursing experience post-grad

LCSW eligible (preferred)

Tools

Milliman Criteria

InterQual Criteria

Basic computer skills

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Huntington Beach Hospital, a member of the Prime Healthcare Foundation, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Huntington Beach Hospital, a member of the Prime Healthcare Foundation, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Founded in 1967, Huntington Beach Hospital is a 131-bed acute-care community hospital. As the only hospital in Huntington Beach, Huntington Beach Hospital is proud to be the community hospital serving the residents of Huntington Beach and the surrounding area for the past 50 years. Fully accredited by The Joint Commission, and with nearly 200 physicians and more than 400 healthcare and other professionals on staff, our team is committed to providing outstanding service in a safe, comfortable, and caring environment. Learn more at https://www.hbhospital.org/.

Responsibilities

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

• Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
• Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.
• Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred.
• Current BCLS (AHA) certificate, preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Experience and knowledge in basic to intermediate computer skills.

Pay Transparency

Huntington Beach Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $46.52 to $62.54. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Part Time < 60

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf