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Case Manager II

Job ID 84043 Date posted 10/30/2017
  • Facility: Sharp Grossmont Hospital
  • City: La Mesa
  • Department: Case Management
  • Category: Case Manager Jobs
  • Job Status: Full-Time
  • Shift: Evening Job
  • FTE: 1.0
  • Shift Start: Variable
  • Shift End Time: Variable
Location
This position is located in La Mesa, CA (San Diego County)
 
Hours
10-hour PM shift position, 2:00 pm to 12:30am or 3:00 pm to 1:30 am.  Weekend coverage every 4th weekend
 
Required Skills and Qualifications

 

  • Current unencumbered California Registered Nurse license
  • BSN or equivalent degree
  • Three years of recent acute care nursing experience or case management experience
  • Three years of recent case management, utilization review, care coordination experience
  • Advanced PC, data management and analysis skills
  • Understanding and knowledge of payer eligibility and reimbursement regulations and impact on the continuum of care
  • Knowledge of use of community resources to coordinate safe discharges from acute care and the ED settings
  • Excellent interpersonal skills, as demonstrated by the ability to work effectively with individuals and/or teams, and across disciplines
  • Excellent communication and negotiation skills, as demonstrated in oral and written forms
  • Ability to work in a collaborative partnership model with Social Workers and other members of the interdisciplinary team, both internal and external
  • Organizational and time management skills as evidenced by capacity to prioritize multiple tasks
  • Ability to mentor and lead a team
 
Preferred Skills and Qualifications
  • Master’s prepared RN
  • CM Certification -  such as Accredited Case Manager (ACM) or Certified Case Manager (CCM)
  • Experience with InterQual and/or MCG and Allscripts

Summary
The RN Case Manager II 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.  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. 
The RN CM II will manage multiple assignments effectively; compose written material; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; and work independently with minimal supervision.  The RN CM II 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 II 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 II will recommend and document patient classification (status and level of care) for all admissions utilizing established criterion sets.
This Case Manager II position is part of the Case Management Department.  The department consists of 70 staff members, including RN case managers and utilization review nurses, social workers, transition of care coaches, and non-clinical resource care coordinators.  The department is a close-knit group that works to provide resources to promote safe discharges and continued wellness in this diverse community.
Sharp Grossmont Hospital is the largest not-for-profit, full-service acute care hospital in the region with 500+ beds. The hospital has outstanding programs in heart care, orthopedics, rehabilitation, robotic surgery, mental health, stroke care and women’s health. In addition, the hospital’s Emergency and Critical Care Center is one of the most technologically advanced emergency and intensive care facilities in the nation.
Sharp Grossmont Hospital is nationally recognized as a MAGNET®-designated hospital for patient care and nursing practices. This designation is the “gold standard” for patient care and nursing excellence and is the highest honor awarded by the American Nurses Credentialing Center.
Essential Physical Requirements may include:
  • Sitting 90% of the time
  • Keyboarding 90% of the time
  • Mousing
  • Ability to lift 25 lbs
  • Pushing/pulling up to 25 pounds
  • Carrying up to 10 pounds
Additional physical requirements of position may be discussed during interview.
Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class.
Keywords:  84043, 82514, Case Manager II Jobs, RN Case Management Jobs, Utilization Management Jobs, UM, Utilization Review, Nursing Jobs, San Diego RN Jobs, Sharp Grossmont Jobs

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