Registered Nurse (RN) - Case Manager

Prime Healthcare; Inglewood (CA); On-site; USD 65,000 - 91,000; Full time

Job summary

Centinela Hospital Medical Center in Inglewood, part of Prime Healthcare, has served the Los Angeles area for 100 years and is an award-winning facility recognized for quality and patient safety. We are seeking an experienced RN to join our case management team and lead efforts to coordinate care.

The role focuses on admission and concurrent review across the continuum, promoting cost containment, and integrating care to achieve safe, efficient outcomes.

Qualifications

• Current California State Registered Nurse (RN) license required.
• 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.
• Basic to intermediate computer skills.

Responsibilities

• Oversee quality and resource management for admitted patients across the care continuum.
• Promote cost containment and integrate health care providers to ensure seamless delivery of care.
• Conduct admission and concurrent review for medical necessity, intensity of service and severity of illness.

Skills

Case management experience

Discharge planning

Nursing leadership

Computer skills

Education

California RN license

Tools

Milliman Criteria

InterQual Criteria

Job description

Overview

At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center is actively seeking new members to join its award-winning team!

Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour STEMI certified emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, inpatient and outpatient rehab programs, and more. Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2024) for hospital safety from The Leapfrog Group.For more information, visit www.centinelamed.com.

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

1. A current California State Registered Nurse (RN) license is required.

2. Five years acute care nursing experience preferred.

3. At least one year experience in case management, discharge planning or nursing management, preferred.

4. Current BCLS (AHA) certificate, preferred.

5. Knowledge of Milliman Criteria and InterQual Criteria preferred.

6. Experience and knowledge in basic to intermediate computer skills.

Pay Transparency

Centinela Hospital Medical Center 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 $46.87 to $65.63. 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

Full Time

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