RN Case Manager: Care Coordination & Discharge Specialist

HCA Healthcare, Inc.; Thousand Oaks (CA); On-site; USD 85,000 - 121,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) plan with match

Tuition assistance/education support

Employee Stock Purchase Plan

Job summary

HCA Healthcare, Inc. is seeking a Case Manager II to organize and coordinate services for patients, ensuring appropriate utilization of the health care system and quality care across the care continuum. The role spans pre-entry to exit phases, coordinating with hospital staff and external resources.

The position emphasizes discharge planning, referrals, and care coordination with emphasis on cost containment and patient quality of life.

Qualifications

• Associate Degree in Nursing is required.
• Bachelor’s degree in Nursing is preferred.
• Current licensure as a Registered Nurse in California.
• Minimum 2 years of case management experience or 3+ years of clinical nursing experience.
• InterQual experience is preferred.

Responsibilities

• Perform admission review to determine appropriateness and medical necessity per criteria and provide payor reviews as requested.
• Maintain a system for monitoring admissions and ensure timely concurrent reviews.
• Provide referrals related to medical necessity, utilization, quality, or risk management and coordinate ongoing care with hospital staff, physicians, and services.
• Plan, coordinate, and facilitate discharge needs including Home Health, DME, placement, community resources, and hospice care.

Skills

Case management experience

Clinical nursing experience

RN licensure in CA

InterQual experience

Education

Associate Degree in Nursing

Bachelor’s degree in Nursing

Job description

HCA Healthcare, Inc. is seeking a Case Manager II to organize and coordinate services for patients, ensuring appropriate utilization of the health care system and quality care across the care continuum. The role spans pre-entry to exit phases, coordinating with hospital staff and external resources.

The position emphasizes discharge planning, referrals, and care coordination with emphasis on cost containment and patient quality of life.