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Case Manager II

Job ID 85810 Date posted 01/30/2018
  • Facility: Sharp HealthCare
  • City: San Diego
  • Department: SCMG Inpt Case Management
  • Category: Case Manager Jobs
  • Job Status: Part-Time
  • Shift: Day Job
  • FTE: 0.5
  • Shift Start: 8 AM
  • Shift End Time: 4:30 PM
This position is located in San Diego County, CA
This Case Manager II position is located at Palomar Health, but may require occasional travel between Sharp HealthCare facilities or provider offices; must provide own transportation.
8-hour day shift position, 8:00 am - 4:30 pm; weekends as needed, currently two weekends/month
Part-time position (0.5 FTE), 40 hours per pay period
Required Skills and Qualifications
  • Current, unencumbered California RN license
  • BSN or equivalent degree
  • 3 years of recent acute care nursing experience or case management experience
  • 3 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 Degree
  • CM certification such as Accredited Case Manager (ACM) or Certified Case Manager (CCM)
  • Experience with InterQual, MCG and/or Allscripts


This part-time RN Case Manager II will primarily work at Palomar Health.  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 the regulatory/financial/utilization review demands t assure patients are receiving care in the appropriate setting and level of care.  The RN Case Manager II position creates a balance between individual clinical needs with the efficient and cost effective utilization of resources while promoting quality outcomes.
This position is in the Sharp Community Medical Group (SCMG) Inpatient Case Management department.  SCMG is one of the state's largest and most successful IPA's.  Established in 1989, it has over 150,000 members and is comprised of 200+ primary care physicians and 500 specialists.  The Health Services division of SCMG coordinates the medical care of members for inpatient and outpatient services and has a staff of 140 nurses, coordinators and support personnel to manage utilization review, case management and quality improvement functions.
Sharp Community Medical Group is part of Sharp System Services (SSS).  Sharp System Services has campuses located in the communities of Kearny Mesa and Serra Mesa and consist of the Spectrum location, the Ruffin Road location and Sharp Operations Center (SOC). These offices provide the centralized integrated system support services to the operating entities within the system. These services include: Case Management, Strategic Planning, Business Development, Information Technology, Compliance, Internal Audit, Legal, Risk Management and Insurance, Contracts, Human Resources, Facilities Management and Development, Clinical Effectiveness, Finance, Nursing, Systems Supply Chain Services, Marketing and Communications, The Sharp Experience and Sharp University.
Essential Physical Requirements may include:
  • Good vision and hearing
  • Ability to speak clearly
  • Standing/walking up to 6 hours a day
  • Ability to sit at desk or computer terminal
  • Ability to ambulate frequently over uneven terrain including pavement, stairs, etc.
  • Use of personal automobile to travel between worksites and attend meetings
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: 85810, Case Manager II Jobs, RN Case Management Jobs, Case Manager Jobs, Managed Care Jobs, Discharge Planning Jobs, Utilization Review Jobs, Utilization Management Jobs, UR, UM, Nursing Jobs, RN Jobs, Nurse Jobs, San Diego Jobs

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