Clinical Case Manager, Case Management, Sharp Mesa Vista Hospital
Job ID: 95099 Date posted: April 12, 2019
- Sharp Mesa Vista
- Case Management
- Case Manager Jobs
- Day Job
- Per Diem
At Sharp, being a nurse means transforming the health care experience for your patients, for your colleagues and for yourself. In a collaborative environment with state-of-the-art facilities and advanced clinical practices, we encourage you to follow your passions wherever they take you.
As a recognized leader in nursing excellence with Magnet® recognitions for high-quality, patient-centered care, we invite you to join us in providing health care the way it should be. We offer a wide variety of nursing positions — from RNs and clinical nurse leads to case managers and clinical nurse specialists.
- Per Diem
- Day Job
- Sharp Mesa Vista
- Case Management
Medical, vision and dental
Generous time off
The per diem Clinical Case Manager performs admission and concurrent review of patients based upon needs regardless of payor sources. The Clinical Case Manager identifies (as early as possible in the admission) patients requiring discharge planning and determines admission necessity based upon severity of illness and intensity of service criteria. Responsibilities also include ensuring a multi-disciplinary approach in planning of care across the continuum. Through assessment and planning, the Clinical Case Manager ensures that patients are placed in the appropriate setting and receiving the appropriate care in a timely manner.
The Clinical Case Manager RN is responsible for obtaining initial and concurrent authorization for inpatient mental health patients with both private and public providers. The Clinical Case Manager performs both telephonic and written reviews and coordinates with staff, as well as physicians to coordinate care and receive authorization for reimbursement. The Clinical Case Manager is also responsible for next level of care authorization and initiating the appeal process.
The Clinical Case Manager position is part of the Case Management department at Sharp Mesa Vista. For more than 40 years, Sharp Mesa Vista Hospital has been a center of excellence, providing diagnosis, management and treatment of mental health, eating disorders and addictive disorders to the San Diego community. The entire staff is deeply committed to eliminating stigma and promoting the fullest recovery for every person.
As the largest behavioral health care provider in San Diego with 149 beds, Sharp Mesa Vista Hospital provides a full range of programs to people of all ages including children, adolescents, adults and seniors challenged by depression, substance abuse or serious mental illness. The hospital’s robust Clinical Research Program has conducted more than 250 clinical trials of investigational medications since its inception in 1963, providing new options and hope for people with mental illness.
Sharp Mesa Vista provides inpatient care and offers outpatient programs throughout the community.
This position is located in Serra Mesa, San Diego County
- Current unencumbered California Registered Nurse licensure
- Bachelor's Degree
- Current BLS certification for Healthcare Providers
- Background and educational experience which will establish credibility with physicians, and non-physician health care practitioners involved in Admission & Triage Discharge planning and case management of chemical dependency patients
- Ability to maintain strict confidentiality
- Knowledge of medical terminology, treatment plans, health care delivery systems, severity of illness and intensity of treatment criteria for patients, preferably in psychiatric and behavioral health setting
- Bachelor of Science degree in Nursing
- Three-five years of experience in a psychiatric/behavioral health setting
- Referral development experience
- In-depth knowledge of Psychiatric and Chemical Dependency diagnosis, disease process, and standard treatment
- Experience working in Utilization Review
- Knowledge and experience obtaining insurance authorization and the appeal process
- Effective interpersonal skills and knowledge of nursing process
- Highly effective communication skills
- Knowledge and application of computer software programs such as Microsoft Office and Word
- Familiarity with Electronic Medical Records (EMR) and web-based case management software
- Ability to rapidly review patient charts for medical necessity, summarize and report patient status and condition to Managed Care companies
Essential Physical Requirements of the position may be discussed during interview.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
Great people, exciting opportunities
“Sharp's commitment to being the best place to work, practice medicine and receive care — essentially to be excellent in every way — is really attractive to me. I have the resources, support and training that I need to be the best nurse I can be.”— Mike, Advanced Clinician, Emergency Department, Sharp Memorial Hospital
“No matter where you work [at] Sharp, you’ll be surrounded by a team of people who want to provide the best care for the communities we serve. You’ll be supported every step of the way in your journey to find the best way you can help others.”— Erica, RN, Intensive Care Unit, Sharp Memorial Hospital
“I love serving my community and having the opportunity to make a difference, especially within my unit. Sharp HealthCare allows me to have the unique opportunity of making a difference in how a patient and their loved ones manage the journey of their illness.”— Dee, RN, Sharp Chula Vista Medical Center