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.

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Education : Bachelor's

Degree Accredited School of Nursing

Required

Experience :

years Nursing - Medical / Surgical Preferred

or

years Nursing - Critical Care

Preferred

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.

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work shift :

5 days one week / 4 days the next in a 2-week pay period.

Set rotation every

Sunday-Wednesday / Thursday.

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Work

Shift :

08.0 - 08 : 00 - 16 : 30 No Waive

(United States of America)

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Pay

Range : $84.77 -

$115.51

Hourly

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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