RN Care Coordination & Utilization Specialist

Desert Oasis Healthcare; Palm Springs (CA); On-site; USD 90,000 - 110,000; Full time

Job summary

Desert Oasis Healthcare seeks a dedicated RN Case Manager to oversee inpatient utilization reviews, discharge planning, and transitions of care. You will collaborate with Hospitalists and specialists to ensure timely consultations, appropriate care levels, and safe discharges.

Must hold a California RN license with acute hospital experience, including telemetry, chart review, and knowledge of LOS criteria. Strong communication and organizational skills are essential for success.

Qualifications

• Current California RN license.
• 2 years recent RN acute hospital experience including telemetry, chart review, and analysis.
• Understanding of Level of Care, Intensity of Service and Severity of Illness criteria.
• Ability to communicate with physicians professionally and assertively.
• Detail oriented with ability to re-prioritize multiple tasks."
• BLS within 60 days of hire for RN Case Managers with direct patient care.

Responsibilities

• Monitors and reviews all inpatient utilization for medical appropriateness and discharge planning.
• Communicates with Hospitalists and Specialists to facilitate timely consultations and care plans.
• Recommends alternative levels of care when appropriate to avoid delays.
• Anticipates delays in physician decision making and intervenes to prevent delays.
• Initiates corrective actions and communicates with Hospitalists or Specialists to facilitate care.
• Escalates to Medical Director when needed to impact decisions.
• Provides daily clinical updates to the team with anticipated next steps.
• Completes discharge screening and ensures timely, safe discharges and SNF transfers when appropriate.
• Ensures documentation supports post-hospital specialty care requests.
• Makes discharge planning recommendations to Hospitalists and Specialists.
• Updates the Daily Hospital Log with significant changes and dispositions.
• Issues denial notifications to patients or their representatives per regulations.
• Identifies and reports quality issues to the Quality Improvement Committee.

Skills

RN license

Communication

Prioritization

Detail oriented

Physician communication

BLS within 60 days

Telemetry experience

Education

RN license (CA)

Job description

Desert Oasis Healthcare seeks a dedicated RN Case Manager to oversee inpatient utilization reviews, discharge planning, and transitions of care. You will collaborate with Hospitalists and specialists to ensure timely consultations, appropriate care levels, and safe discharges.

Must hold a California RN license with acute hospital experience, including telemetry, chart review, and knowledge of LOS criteria. Strong communication and organizational skills are essential for success.