RN Case Manager, Inpatient - (Job Number: MEM007297)

MemorialCare; Fountain Valley (CA); On-site; Full time

Job summary

A leading healthcare organization in California is seeking an RN Case Manager specialized in inpatient care. The role demands exceptional nursing and communication skills to ensure patient needs are met effectively within the acute care setting. Candidates should hold an active California RN license and have experience in inpatient nursing and case management. This position offers competitive compensation and numerous benefits aimed at employee health and wellness.

Benefits

High quality health insurance plan options

Additional compensation for shifts and bonuses

Qualifications

• 3-5 years of clinical experience in inpatient nursing or related field required.
• Previous inpatient Case Management experience preferred.
• Bachelor of Science in Nursing or related advanced degree preferred.

Responsibilities

• Conduct on-site clinical reviews and admission protocols.
• Document as per regulatory guidelines in electronic systems.
• Support after hours and weekend case management activities.

Skills

Microsoft Word

Microsoft Excel

Microsoft Outlook

Evidence-based criteria

Clinical coverage guidelines

Education

Current California Registered Nurse license (RN)

Associate's degree (AA) in nursing

Basic Life Support (BLS)

Job description

RN Case Manager, Inpatient - (Job Number: MEM007297)

Pay Competitive

Location Fountain Valley/California

Employment type Other

Job Description

Req#: MEM007297 !*!

At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.

Position Summary

Under minimal supervision and in a professional manner, the Registered Nurse inpatient case manager performs all job duties to the highest level of customer service and assistance to both internal and external customers of Memorial Care Medical Foundation. This position requires exceptional clinical and communication skills in support of patients, their care givers and providers when seen at or admitted to the acute care setting.The nurse case manager is required to meet all elements as required by hospital governing bodies as well as managed care delegation requirement for this position to ensure appropriate admissions, ongoing concurrent treatment, discharge planning and transitions of care for the populations served.The position is critical to the organization’s inpatient utilization and quality outcomes for populations we manage.

Essential Functions and Responsibilities of the Job

• On-site, clinical reviews, admission and concurrent, for GNP patients in identified settings
• Document appropriately and per hospital DNV and CMS regulatory requirements within aligned electronic UM/CM system
• Provide discharge planning and transitions of care per assignment and in accordance with DNV, Health Plan and DOF
• Support after hours and weekend case management activities based on business needs and per standard workflows and policies as assigned
• Be at work and be on time
• Follow company policies, procedures and directives
• Interact in a professional, positive and constructive manner
• Prioritize and multitask

Pay Range: $47.06 – $68.23 hour

Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more... Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

!*!

Experience

Required:

• Work experience in Microsoft Word, Microsoft Excel and Microsoft Outlook.
• Work experience applying evidence-based criteria (i.e.: MCG, lnterqual); Health plan medical policy / clinical coverage guidelines.
• Inpatient nursing or related field 3-5 years clinical experience.

Preferred

Previous inpatient Case Management experience. 1 year or greater.

• Previous and or ability to learn use of electronic medical record, UM/CM platforms or electronic health record preferred.
• Knowledge of CMS (Centers for Medicare and Medicaid Services) coverage policies required.

Education

Required:

• Current California Registered Nurse license (RN)
• Associate's degree (AA) in nursing or equivalent from a two-year college or technical school.
• Basic Life Support (BLS)

Preferred:

• Bachelor of Science in Nursing or related HealthCare advanced degree
• CCM preferred.

About the company

MemorialCare is Orange & LA counties' leading integrated health system with the best doctors, urgent care, & pediatricians. Join our family & see the difference today!

Notice

Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at [e-mail] or 407-000-0000.

Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.

An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report . NYC applicants may request an alternative process or accommodation at [e-mail] or 407-000-0000.