Job Responsibilities

• Case Managers are licensed nursing professionals who are responsible for care coordination, care transitions, discharge planning, and utilization review.

• Through use of evidence-based practices, effective communication and utilization of available resources, Case Managers work in collaboration with the interdisciplinary team to advance patients care plan, ensure the appropriate level of care, and prevent unnecessary admissions and readmissions.

• Responsible for promoting quality and cost-effective outcomes while assuring a positive patient experience.

• Has frequent contact with patients, families, physicians, nursing, interdisciplinary team members, quality, insurance companies, medical directors, post-acute providers, and community resources.

• Interprets regulations, health plan benefits, policies and procedures, and ensures compliance with federal, state, and local requirements.

Qualifications

• Bachelor’s degree in nursing required.

• Three years’ experience in the acute care setting and/or Case Management experience preferred.

• Minimum 1 year experience in case management and/or managed care strongly preferred.

• Ability to work well with physicians, health care providers, discharge planning and outside agencies regarding continued care/treatment or hospitalization.

• Advanced communication skills in advocacy, negotiation and conflict resolution.

• Ability to perform utilization management functions to ensure the appropriate level of care and ensure appropriate utilization of resources.

• Computer literate, with experience in word processing, data analysis and presentation development.

License/Certification/Registration Requirements

Current California RN license.

CCM (Certified Case Manager) or ACM (Accredited Case Manager) certification preferred.

Ages of Patients Served

This position will serve all age groups.

Salary Range:

$85.14 - $111.21 USD Hourly