RN, Care Manager

MemorialCare; Fountain Valley (CA); On-site; USD 79,000 - 124,000; Full time

Job summary

MemorialCare is seeking an RN Care Manager in Laguna Hills to perform utilization review, coordinate multidisciplinary care, and plan transitions for an assigned caseload. You will conduct clinical assessments, communicate with payors for authorizations, and implement patient/family centered plans across the continuum to optimize outcomes.

The role requires strong communication with patients, families, physicians, and the care team, and adherence to quality and financial targets within

Qualifications

• This role requires an active RN license and CA registration.
• Experience in care coordination and utilization review is preferred.
• Strong communication with patients, families and care teams.

Responsibilities

• Utilize the Utilization Review plan and nursing process for case management.
• Coordinate patient care across the continuum to achieve outcomes.
• Demonstrate critical thinking in clinical decision-making.
• Teach, guide and consult with healthcare teams to maintain care standards.
• Maintain patient documentation per clinical information system requirements.
• Promote a safe and effective work environment.
• Mentor new staff and uphold professional conduct.
• Protect patient privacy and confidentiality in all forms.
• Demonstrate discretion and tact in interactions.
• Integrate role-specific competencies into daily practice.
• Be punctual and adhere to policies.
• Engage positively with colleagues and patients.
• Prioritize tasks and multitask to meet benchmarks.

Skills

Utilization Review

Care Coordination

Leadership

Critical Thinking

Documentation

Patient Privacy

Education

Registered Nurse (RN) license - CA

Tools

EMR / Electronic Medical Records

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.