RN Case Manager - Loan Forgiveness & $20,000 Sign-on Bonus - Full Time, Days (Tustin)
Company: Foothill Regional Medical Center
Location: Tustin
Posted on: January 26, 2023
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Job Description:
We are hospitals and affiliated medical groups, working closely
together for the benefit of every person who comes to us for care.
We build comprehensive networks of quality healthcare services that
are designed to offer our patients highly coordinated, personalized
care and help them live healthier lives. Through collaboration, we
strive to provide all of our patients and medical group members
with the quality, affordable healthcare they need and deserve.The
RN Case Manager is responsible for performing clinical assessment
and reassessment of acute care Inpatients for the purpose of
performing utilization review, resource management and safe
discharge planning. The RN Case Manager prioritizes, plans,
organizes, and implements timeliness of care. Collaborates with the
interdisciplinary healthcare team to promote and coordinate the
delivery of safe and cost-effective patient care, transition of
care and discharge planning. The RN Case Manager advocates for
patient self-determination and choice. Practices clinical
competence in evaluations and planning with awareness and respect
for patient and family diversity. Monitors and coordinates resource
utilization throughout the continuum of care and evaluates
timeliness of services. Performs admission, continued stay and
discharge review utilizing medical staff-approved decision support
criteria.Job Responsibilities/DutiesCollaborates as needed with the
patient and family to optimize client outcomes. May include work
with community, local and state resources, primary care provider,
and members of the health care team, payer, and other relevant
health care stakeholders to facilitate appropriate patient
transfers, discharges and transitions of care. Identifies timely
and effective alternative lower level of care settings for patient
care in accordance with the patient's medical necessity, stability,
the patients' preferences and health plan benefits. Identifies
timely post-hospital needs and arranges for services as
appropriate. Provides patient and family appropriate resources
and/or referrals. Makes timely and appropriate referrals to, and
seeks consultation with others when needed, the patient-centered
provision of services; such as Social Services (i.e., Durable Power
of Attorney).Reviews medical necessity utilizing medical
staff-approved evidence-based decision support criteria. to
determine appropriate level of care and length of stay. Ensures
utilization review is completed and documented concurrently, and
provided to the patient's payer as required. Ensures timely
escalation of unresolved care coordination issues to the
appropriate level. Enters delays in service and avoidable days
regarding exceeded payer LOS variances. Communicates denials and
physician related utilization management practices to immediate
supervisor same day as identified.Collaborates with
patients/caregivers to set goals consistent with physician
treatment plans, and patient resources and choices. Collaborates
with the multidisciplinary team for timely discharge planning
assessments and reassessments and documents concurrently in the
patient's medical record in compliance with hospital policy and all
regulatory agencies. Provides appropriate instructions to discharge
care coordinators as needed.Acts as an effective liaison to medical
staff to ensure continuity and congruity of hospital services in
accordance with the patient's plan of care.Participates in patient
and family meetings; respecting and promoting patient choice and
documents informed decision making. Utilizes knowledge of
psycho-social and physical factors that affect functional status on
discharge.Contributes requested data for the Utilization Management
Committee.QualificationsMinimum Education: Bachelor of Science in
Nursing preferred.Minimum Experience: One (1) year of case
management experience required. Computer/EMR Proficiency and
Literacy required. Knowledge of CMS, Medicare, Medi-Cal and Managed
Care reimbursement. Familiarity of Joint Commission, CMS, CDPH
requirements. Excellent written and verbal communication skills in
English. Ability to establish and maintain effective working
relationships across the organization. Ability to facilitate and
lead interdisciplinary rounds. Familiarity with AllScripts Care
Management preferred. Proficiency with Milliman Care Guidelines or
Interqual preferred. Bilingual skills to communicate effectively
with patients and families preferred.Req. Certification/Licensure:
Current Licensure as a Registered Nurse in the State of California
required. Certified Case Manager (CCM) preferred.Sign On Bonus
Eligibility: To be eligible for the Sign On Bonus, you must have
one or more years (1+) of acute care RN hospital experience.
Current Alta Hospital employees are not eligible and former Alta
Hospital employees may not be eligible. The Sign on Bonus Program
is only available for full-time RN positions. Bonus payments are
made in increments over the course of 18 or 24 months to active
employees in good standing.Employee Value PropositionProspect
Medical Holdings, Inc., is guided by a diverse and highly
experienced leadership core. This group maintains the vision that
has made Prospect a needed difference-maker in the lives of so many
patients today, and many executives contribute to our continued
efforts. As a member of our highly effective team of professionals,
benefit eligible positions will receive:Company 401KMedical,
dental, vision insurancePaid time-offLife insuranceHow to ApplyTo
apply for this role, or search our other openings, please visit and
click on a location to begin your journey to a new career with
us!We are an Equal Opportunity/ Affirmative Action Employer and do
not discriminate against applicants due to veteran status,
disability, race, gender, gender identity, sexual orientation or
other protected characteristics. If you need special accommodation
for the application process, please contact Human Resources.EEOC is
the Law: Internal applicants not eligible for the Sign On
Bonus.Position SummaryEmployment Status: Regular Full-timeShift:
DaysWork Schedule: VariableAddress: Foothill - 14662 Newport
AvenueReasonably expect to pay:Min: $46.13 Max: $63.43Union Pay
Info:
Keywords: Foothill Regional Medical Center, Tustin , RN Case Manager - Loan Forgiveness & $20,000 Sign-on Bonus - Full Time, Days (Tustin), Healthcare , Tustin, California
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