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Case Manager - Complex Case Mgmt

Job ID 83874 Date posted 10/30/2017
  • Facility: SRS Administration
  • City: San Diego
  • Department: Utilization Management
  • Category: Case Manager Jobs
  • Job Status: Per Diem
  • Shift: Day Job
  • FTE: 0.0
  • Shift Start: 8:30 AM
  • Shift End Time: 5 AM
This position is located at the Sharp Spectrum site in Kearny Mesa, CA (San Diego County)
Per Diem Day Shift; No Weekends
Required Skills and Qualifications
  • Current, unencumbered California RN license
  • 5 years’ experience in the acute adult patient care setting, including ICU or intermediate care units, Medical/Surgical Nursing and/or Home Health
  • 2 years’ Utilization/Case Management experience, preferably in a managed care setting
  • Working knowledge of computer programs
  • Knowledge and understanding of applicable accreditation and regulatory statutes
  • Knowledge and understanding of utilization, case management and healthcare finances
  • Highly skilled in communication, patient engagement and motivational interviewing
  • Ability to critically think using creative problem solving to achieve resolution
  • Organizational skills to efficiently and effectively manage large caseload to achieve productivity metrics
Preferred Skills and Qualifications
  • BSN degree
  • Certified Case Manager (CCM)

The Complex Case Manager will provide guiding principles, interventions and strategies that are targeted at the achievement of client stability, wellness, and autonomy through advocacy, assessment, planning, communication, education, resource management, care coordination, collaboration and service facilitation.  Interventions and strategies are based on the needs and values of the client and are accomplished in collaboration with all service providers.  Care provided is appropriate, effective, client-centered, timely, efficient and equitable.
The Complex Case Manager is part of the Utilization Management Department of Sharp Rees Stealy (SRS).  The UM Department staff applies health plan criteria and/or established organizational guidelines to each case review and adheres to all regulatory mandates.  The UM department works closely with the medical staff of SRS and hospitalists, establishing collaborative and professional relationships and are consistently involved in process improvement efforts to identify opportunities for improvement in care management for our members.
With 450 primary and specialty care physicians providing care at 22 facilities throughout the region, Sharp Rees-Steely Medical Group is one of the largest, most comprehensive medical groups in San Diego County, and is recognized for excellence in patient satisfaction and clinical care. For patient convenience and improved coordination of care, Sharp Rees-Steely offers services like laboratory, radiology, physical therapy and urgent care within each clinic or nearby.
Essential 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:  Complex Case Manager, Case Manager – Complex Case Management, RN Case Management, CCM, Quality, Nursing Jobs, Nurse

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