RN - Case Manager - BSN - AS Utilization Management - FullTime - 8 Hour - Days

Job Description :

The role of the inpatient case manager is one of patient advocate

of appropriate utilization of resources. The inpatient case manager

applies the process of assessment, planning, implementation,

monitoring, evaluation and coordination of care to meet the

patient's health care needs through hospitalization and transition

back to the community and does this in coordination with the

interdisciplinary health team.

The RN Case

Manager is expected to function within the full scope of the

nursing practice with specialized focus on care coordination,

compliance, transition management, education, and utilization

management.

Education :

Bachelor's Degree Accredited School of Nursing Required

Experience :

3 years Nursing - Medical / Surgical Preferred

or

3 years Nursing - Critical Care Preferred

2 years Care Coordination

• Case Management Preferred or Equivalent Work Experience

Certifications / Licensures :

RN Registered Nursing - California Board of Nursing Required

BLS Basic Life Support -

American Heart Association Required

ACM Accredited Case

Manager - ACMA American Case Management Association

or

CCM Certified Case Manager - CCMC Commission for Case Manager

Certification Strongly Preferred

Skills :

Strong written and verbal communication skills.

Effectively motivates

teams.

Strong knowledge of

Medicare and Medi-Cal guidelines and benefit resources as

applicable to hospitalization and transition planning.

Working know ledge of

common diagnoses and procedures and the impact this w ill have to

patients / families and their ability to manage their care outside of

the hospital. Specialized know ledge may be required for certain

areas of practice.

Knowledge of individual and family development over the life span,

and the influences of cultural and spiritual values in health care.

General knowledge of

commercial coverage plans and usually covered benefits. Strong

understanding of various reimbursement models and impact to care

delivery, patient management and reimbursements such as ACOs, DRGs,

Full Risk, etc.

Strong

understanding of the criteria, rules and regulations around

Inpatient, Observation and Outpatient levels of patient management.

Strong know ledge of

geriatrics and the impact to health and function in the aged as w

ell as a working know ledge of chronic / progressive disease states

such as CHF, COPD, Diabetes and End Stage Renal Disease, etc.

Clear understanding of the

role of the inpatient Social Worker and Palliative Care Resources.

Ability to plan, organize,

manage time and prioritize work in collaboration with others.

Ability to work

independently and as a part of a multidisciplinary team.

Effective problem solving

and conflict resolution skills.

Ability to work

respectfully and creatively with clients of diverse functional

abilities, social, economic, and cultural backgrounds to support

both client autonomy and client safety.

Leadership skills to

delegate and provide direction / guidance to staff and hold others

accountable.

Able to learn

and work in a variety of computer programs, including EPIC,

Allscripts, InterQual, and Microsoft Outlook.

work shift : 5 days one

week / 4 days the next in a 2-week pay period. Set rotation every

Sunday-Wednesday / Thursday.

Work

Shift : 08.0 - 08 : 00 - 16 : 30 No Waive (United

States of America)

Pay

Range :

$84.77 - $115.51 Hourly Offer

amounts are based on demonstrated / relevant experience and / or

licensure. Pay will be adjusted to the local market if hired

outside of the Bay Area .

Note : Positions at JMH which

are exempt (not eligible for overtime) under the level of Manager

are listed as hourly for compensation purposes on this posting. The

work shift will contain the word 'exempt' on it.

Scheduled Weekly Hours :

36