RN Case Manager-Sharp Memorial Hospital - Per Diem - Days

sharp; San Diego (CA); On-site; USD 99,000 - 138,000; Full time

Job summary

Sharp HealthCare is seeking an RN Care Manager to assess, coordinate, and monitor patient care in the inpatient and emergency department areas. You will balance clinical needs with utilization review and work with a multidisciplinary team to ensure appropriate care settings.

The role requires 3 years of acute care or case management experience and an active California RN license, with CCM preferred. On-site hospital-based position with weekend coverage as needed.

Qualifications

• 3 years recent acute care nursing experience or case management experience.
• California Registered Nurse (RN) license is required.
• Preferred: Certified Case Manager (CCM) certification.

Responsibilities

• Assess, develop, implement, coordinate and monitor a plan of care with the care team.
• Balance clinical needs with regulatory and utilization review demands.
• Lead discharge planning and care transitions in inpatient and ED settings.
• Collaborate with physicians, social workers and interdisciplinary teams.

Skills

Case management experience

Nursing

Clinical coordination

Education

RN license California Board of RN

Job description

Hours :

Shift Start Time:Variable Shift End Time:Variable

AWS Hours Requirement:8/80 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:As Needed

On-Call Required:No

Hourly Pay Range (Minimum - Midpoint - Maximum):$71.830 - $78.080 - $100.330

The stated pay scale reflects the range as defined by the collective bargaining agreement between Sharp HealthCare and Sharp Professional Nurses Network, United Nurses Associations of California/Union of Health Care Professionals, NUHHCE, AFSME, AFL-CIO. Placement within the range is based on years of RN experience.

What You Will DoThe RN CM assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the appropriate setting and level of care. The position creates a balance between individual clinical needs with the efficient and cost effective utilization of resources while promoting quality outcomes.

Required Qualifications 3 Years Recent acute care nursing experience or case management experience.California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED

Preferred Qualifications Bachelor's Degree in NursingCertified Case Manager (CCM) - Commission for Case Manager Certification -PREFERRED

Essential Functions

Professional developmentThe RN CM will:Actively participates in the performance planning, competency and individual development planning process.Maintain current knowledge of case management, utilization management, and discharge planning, as specified by Sharp, federal, state, and private insurance guidelines.

Core principlesThe RN CM will make timely referrals to ensure that the patient is receiving the appropriate care, in the appropriate setting and using the appropriate utilization standards as set by community and professional standard as adopted by the medical staff.The RN CM will assure that the patients from all age groups proceed efficiently through the course of hospitalization and beyond through the continuum of care.The RN CM will relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, collaborate and accept direction.The RN CM performs other duties as needed.

Organizational relationshipsThe RN CM will work closely with the healthcare team in reaching unit, facility, and system/network organization goals including reductions in length of stay, decreasing denials, improvement of care transitions, and reduction in avoidable readmissions, improved patient experience, and other quality initiatives.In the emergency departments, the RN CM will work collaboratively with other members of the interdisciplinary team to develop relationships and provide pre admission status recommendations for admissions as well as implement a comprehensive, integrated discharge plan from the emergency department(ED) for patients who are being discharged to a lower level of care.The RN CM will recommend and document patient classification (status and level of care) for all admissions utilizing established criterion sets.The RN CM has accountability for maintaining compliance contractual and regulatory compliance with medical groups as applicable and the hospital.The RN CM will have excellent interpersonal skills demonstrated by the ability to work effectively with individuals and or teams across disciplines.

Care coordination and discharge planningWithin 24 hours of admission the RN CM will interview each patient/family for anticipated needs post hospitalization. The plan and interventions will be documented in the EMR (e.g., Cerner), and case management software (e.g., Allscripts Care Management).The RN CM will develop and document a plan for the day and plan for the stay with patient, family, providers, and nursing staff.The RN CM will be responsible for leading the daily care coordination (multidisciplinary) rounds, update the plan, and facilitate necessary coordination of services.The RN CM will document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion services.The RN CM will prepare patient/family for discharge. Document expected discharge date per protocol and arrange discharge pick up appointment with family or significant other.In collaboration with SW partner, the RN CM will follow standards for routine patient/family conference.The RN CM will ensure effective and safe patient handovers to next level of care; work closely with ambulatory care manager (ACM) at the system level, in