RN Case Manager - Inpatient Case Management - Per Diem - Day Shift - Marina Hospital

Cedars-Sinai; California; On-site; USD 90,000 - 135,000; Full time

Job summary

Cedars-Sinai in California is seeking a Registered Nurse Case Manager to plan and coordinate patient care from admission through discharge. You will collaborate with the care team to ensure optimal treatment, review care for appropriateness, and plan home care and discharge needs.

This onsite role requires an California RN license, 2 years acute care nursing, and 1 year in Case Management; CCM/ACM preferred.

Qualifications

• Minimum 2 years of nursing experience in an acute care setting.
• 1 year of Case Management experience preferred.
• Experience with Utilization Review is strongly preferred.

Responsibilities

• Evaluates and assesses patients within established timeframes.
• Documents reviews for assigned patients using utilization review tools.
• Provides telephonic review for contracted/private patients with on-site or remote reviewers.
• Coordinates discharge planning and home health needs with social workers and third-party payers.
• Educates patients and families on hospitalization and ongoing care.
• Completes required case management reports for regulatory bodies and insurers.

Skills

Case Management

Patient Education

Discharge Planning

Utilization Review

Education

Associate's degree in Nursing

Bachelor's degree in Nursing (preferred)

Tools

Utilization Review Tools

Job description

Job Description

What You Will Do in This Role:

A Registered Nurse Case Manager plans and coordinates care of the patient from pre-hospitalization through discharge. Works with all members of the health care team to ensure a collaborative approach is maintained in care and treatment of the patient. Reviews care and treatment for appropriateness against screening criteria and for infection control, quality services for continued stay and through discharge. Plans and coordinates home care services and needs. Coordinates the discharge planning function in conjunction with the social worker. Participates in education on and implementation of clinical guidelines and protocols. Provides or arranges patient teaching as appropriate. Works closely with social workers to integrate psychosocial management of patient/family needs.

Primary Duties and Responsibilities:

• Performs evaluation and or assessment within the established/communicated timeframe
• Documents appropriate reviews for assigned patients using utilization review tool.
• Provides telephonic review for identified contracted/private patients collaborates with on-site and/or outside reviewers.
• Keeps patients informed of progress and provides information related to disease progression.
• Collaborates with discharge planner to make orders and arranges for home care equipment, healthcare needs, and works with third-party payers to validate orders.
• Educates patients and families on all aspects of patients’ hospitalization and continuing care.
• Assumes responsibility for timely completion of required case management reports for regulatory bodies, health plans, and insurance carriers.
• Interacts professionally with patient/family/caregivers and involves them in the formation of the plan of care and discharge needs.
• Coordinates with multidisciplinary team to ensure the identification of a safe and appropriate discharge plan for each assigned patient.
• Documentation meets current standards and policies.
• Maintains department cleanliness and safety.

Shift: 8:00AM - 4:30PM, This position is an onsite role.

Qualifications

Education:

• Associate's degree in Nursing (required).
• Bachelor's degree in Nursing (preferred).

Certifications/Licenses:

• Current and valid California RN License (required).
• Certified Case Manager (CCM) or Accredited Case Manager (ACM) (preferred).

Experience:

• Minimum of 2 years of nursing experience in an acute care setting (required).
• Minimum of 1year of Case Management experience (preferred).
• Experience with Utilization Review (strongly preferred).