RN Case Manager - Care Coordination - Full Time 8 Hours Day (7:30 AM to 4:00 PM) (Union, Non-Exempt)

University of Southern California; Arcadia (CA); On-site; USD 69,000 - 106,000; Full time

Job summary

The Case Manager at University of Southern California Arcadia Hospital partners with physicians and the interdisciplinary team to coordinate utilization management, discharge planning, and patient care. The goal is to improve clinical outcomes and patient satisfaction while controlling costs and ensuring timely payer communications.

You will manage a designated patient caseload, facilitate pre-certification and payer authorizations, and support clinical documentation to reflect severity of

Qualifications

• Registered Nurse (CA Board of Registered Nursing).
• Basic Life Support (BLS) Healthcare Provider certification.
• Workplace Violence Training Program.

Responsibilities

• Facilitate pre-certification and payer authorization processes.
• Coordinate utilization management and discharge planning across care continuum.
• Lead collaboration with physicians, payers, and families to remove barriers.
• Coach clinical documentation efforts to reflect severity of illness and intensity of service.
• Manage a designated patient caseload and optimize length of stay.

Skills

Discharge planning

Utilization management

Payer coordination

Clinical documentation support

Interdisciplinary collaboration

Strong communication

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Job description

The purpose of the Case Manager position is to support the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management, care facilitation, and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources. Specific functions within this role include: facilitation of pre-certification and payer authorization processes, facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement, application of process improvement methodologies in evaluating outcomes of care support and coaching of clinical documentation efforts and serving as a clinical resource for coders, ensuring that documentation accurately reflects severity of illness and intensity of service coordinating communication with physicians.

Pay Transparency

The hourly salary rate range for this position is $49.86- $76.69. When extending an offer of employment, the University of Southern California Arcadia Hospital considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, State, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

Minimum Education:

• Associate's Degree Nursing

Minimum Skills:

• Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
• Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.
• Excellent interpersonal communication and negotiation skills.
• Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components.
• Understanding of pre-acute and post-acute venues of care and post-acute community resources.
• Strong analytical, data management, and PC skills.

Required Certifications:

• Registered Nurse - RN (CA Board of Registered Nursing)
• Basic Life Support (BLS) Healthcare Provider from American Heart Association
• Workplace Violence Training Program

Preferred Education:

• Bachelor's Degree Nursing

Preferred Experience:

• 3 years Clinical experience in Utilization Review and Discharge Planning in an Acute Hospital strongly preferred.