RN Case Manager

PIH Health Hospital; Whittier (CA); On-site; USD 75,768 - 120,540; Full time

Job summary

PIH Health Hospital in Whittier, California seeks a Registered Nurse (RN) Case Manager to provide care coordination and discharge planning. This role involves close collaboration with nursing and physicians to ensure positive patient transitions through the healthcare system.

The ideal candidate will hold an active California RN License, possess excellent communication skills, and have a minimum of 5 years of hospital nursing experience. The position is key to maintaining high-quality patient care and meeting core healthcare measures.

Qualifications

• Maintain an active California RN License.
• Obtain ACM or CCM within 3 years of hire.
• Minimum of 5 years hospital nursing experience.

Responsibilities

• Coordinate care by creating partnerships with nursing and physicians.
• Perform discharge planning and utilization review.
• Manage patient and family expectations for transitions of care.

Skills

Excellent verbal, written, and organizational skills

Ability to follow chain of command

Knowledge of medical terminology

Self-motivated and results oriented

Demonstrate sound decision making

Proficiency with main-frame and personal computers

Education

Active California RN License

ACM (Accredited Case Manager) or CCM (Certified Case Manager)

Minimum of 5 years hospital nursing experience

Job description

Job Summary

The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace the care for outcomes while meeting core measures within the appropriate level of care. The RN Case Manager provides discharge planning by collaboratively determining level of care needs beyond acute care, providing decision support to patients and families and physicians, managing patient and family expectations and ensuring a smooth transition to the next level of care and services. The RN Case Manager performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity to achieve reimbursement for services and ensuring appropriate utilization of hospital resources.

Employer

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting‑edge advancements, quality of care and healthcare technology.

Required Skills

• Excellent verbal, written, and organizational skills required.
• Ability to follow chain of command.
• Knowledge of medical terminology and current third party payor reimbursement methodologies.
• Self‑motivated and results oriented.
• Must be able to demonstrate sound decision making and prioritization skills.
• Proficiency with main‑frame and personal computers.

Requirements

• Maintain an active California RN License.
• Obtain ACM (Accredited Case Manager) or CCM (Certified Case Manager) within 3 years of hire.
• Minimum of 5 years hospital nursing experience.

Preferred

• BSN or MSN degree.
• CCM or ACM (Certified Case Manager, Accredited Case Manager).
• Previous experience in case management.

Address

12401 Washington Blvd.

Salary

55.00-87.50

Shift

Days