RN Case Manager: Care Coordination Lead

Keck Medicine of USC; Los Angeles (CA); On-site; USD 65,000 - 138,000; Full time

Job summary

Keck Medicine of USC is seeking an RN case manager to provide care coordination, evaluating options and services to meet an individual's health care needs and promote cost-effective, quality outcomes. You will serve as a consultant to the health care team managing specific patient populations.

The role integrates utilization and quality management, discharge planning, and coordination of post-hospital care including transfers to alternative levels of care, while leading and mentoring staff and

Qualifications

• Req Associate’s Degree Nursing.
• Req 3 years clinical experience.
• Req Knowledge of case management principles and healthcare management.
• Req Problem solving skills and ability to multi-task.

Responsibilities

• Clinical Care Coordination.
• Manage a caseload of 18-20 patients.
• Utilize online Work list to manage daily caseload.
• Assess patient needs via clinical assessment and data sources.
• Analyze and interpret data with care team to develop a plan.
• Ensure physician-specific plan of care for all patients.
• Participate in interdisciplinary meetings.
• Initiate discharge planning within 24 business hours of admission and document in system.
• Document changes to discharge plan as they occur.
• Collaborate with social workers to meet psychosocial needs.
• Participate in physician and unit rounds.
• Complete Medicare One Day Stay forms timely.
• Complete disposition forms for Medicare patients.
• Demonstrate sound clinical knowledge base.
• Educate health care team on observation status and reimbursement.
• Represent department professionally.
• Assist with orientation of new staff.
• Delegate and supervise Case Management Assistants.
• Refer to Physician Advisor with accurate clinical information.
• Participate in InterQual competency testing as requested.
• Identify and participate in core measures for appropriate patients.
• Contribute to hospital quality improvement processes.
• Adhere to TENET policies and procedures.
• Identify compliance and ethical issues and report appropriately.
• Respect patient/family values and involve them in care decisions and discharge planning.
• Identify educational needs for discharge and inform patient/family.
• Coordinate with post-acute services to ensure safe discharge.
• Propose alternative treatment options for cost-effective plans.
• Remove barriers to optimal patient care.
• Document avoidable delays and maintain payer communications.

Education

Associate’s Degree in Nursing

Bachelor’s Degree in Nursing

Job description

Keck Medicine of USC is seeking an RN case manager to provide care coordination, evaluating options and services to meet an individual's health care needs and promote cost-effective, quality outcomes. You will serve as a consultant to the health care team managing specific patient populations.

The role integrates utilization and quality management, discharge planning, and coordination of post-hospital care including transfers to alternative levels of care, while leading and mentoring staff and