RN, Care Manager

MemorialCare; Colonia Juarez (CA); On-site; USD 79,000 - 124,000; Part time

Job summary

MemorialCare in Laguna Hills is seeking an RN Care Manager for a per-diem, day shift. The role focuses on utilization review, care coordination, and transition planning for an assigned patient caseload.

Responsibilities include clinical assessment, payor communications for authorizations, and implementing patient/family centered care plans across the continuum to achieve optimal outcomes.

Qualifications

• Three to five years acute care experience with utilization review, discharge planning and risk management preferred.
• California RN License required; BSN or higher preferred.
• Heart Association BCLS required; CCM and specialty certifications preferred.

Responsibilities

• Utilizes the Utilization Review plan and nursing process for case management.
• Coordinates patient care across the continuum to meet outcomes.
• Communicates with payors for authorizations and supports a patient/family centered plan of care.
• Mentors staff and maintains patient privacy and confidentiality.

Skills

Acute care experience

Utilization review

Discharge planning

Case management

Education

California RN License

BSN or higher preferred

ACLS Certification

CCM certification preferred

Specialty Certification preferred

Tools

Computer & Internet

Order entry

Job description

Job Title: RN, Care Manager

Location: Laguna Hills

Department: Care Coordination

Status: Per-diem

Shift: Day

Pay Range*: $57.31/hour - $89.96/hour

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

This position requires the full understanding and active participation in fulfilling the mission of Saddleback Medical Center. It is expected that the employee demonstrate behavior consistent with our core values: Integrity, Accountability, Best Practices, Compassion and Synergy. The employee shall support Saddleback Medical Center’s strategic plan and participate in and advocate performance improvement/patient safety activities.

The RN, Case Manager is responsible for utilization review, multi-disciplinary care coordination and transition planning, for an assigned patient caseload. Role functions include: clinical assessment, payor communication for needed authorizations, and implementation of a patient / family centered plan of care across the continuum, to ensure optimal patient outcomes, including safe and timely transitions. The success of the department is inherent in the individuals’ ability to demonstrate positive, professional communication with patients/families, physicians, and other providers, and to meet / exceed benchmarks for quality outcomes, and financial targets.

Essential Functions and Responsibilities of the Job

1. Utilizes the Utilization Review plan, nursing process and practice standards as a framework for the case management of patient care.
2. Demonstrates leadership in the coordination of patient care across the healthcare continuum with progress toward meeting desired patient outcomes.
3. Demonstrates the ability to utilize effective critical thinking skills.
4. Demonstrates the ability to teach, guide and consult with healthcare team members to maintain and improve patient care standards.
5. Demonstrates knowledge of the clinical information system and applies principles to patient documentation.
6. Contributes to an effective and safe working environment.
7. Serves as a role model and mentors new staff members.
8. Demonstrates knowledge and understanding of patient privacy rights. Maintains confidentiality of all medical, financial and other sensitive material in printed, electronic or verbal form Demonstrates excellent customer service skills by managing and acknowledging patient-family-significant other expectations.
9. Demonstrates tact, sensitivity and discretion.
10. Demonstrates the ability to integrate knowledge of job specific competencies.
11. Ability to be at work and be on time
12. Ability to follow company policies, procedures and directives
13. Ability to interact in a positive and constructive manner
14. Ability to prioritize and multitask

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Minimum Requirements

Qualifications/Work Experience:

• Three (3) to five (5) years Acute Care experience in clinical areas and specifically in area of specialization with knowledge of utilization review, discharge planning activities, government and managed care regulations, quality improvement principles and risk management preferred
• Computer, internet, order entry and word processing experience preferred.

Education/Licensure/Certification:

• Current California RN License required
• Bachelor’s Degree in Nursing or higher preferred
• Current American Heart Association Basic Cardiac Life Support Card
• Case Management Certification preferred
• Specialty Certification preferred