RN Case Manager PRN Week Days

$103,646 - $131,456/Yr

ScionHealth - Rancho Cucamonga, CA

Full-time

Rancho Cucamonga, CA

Hospitals

About the position

The RN Case Manager PRN Week Days position is responsible for coordinating and facilitating patient care through collaboration with the Interdisciplinary Care Transitions team. The role involves monitoring patient care, ensuring compliance with external review agencies, and providing support through assessment, care planning, and evaluation. The aim is to enhance patient management quality and satisfaction while promoting continuity of care and cost-effectiveness.

Responsibilities

• Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
• Monitors all areas of patients' stay for effective care coordination and efficient care facilitation.
• Remains current regarding reimbursement modalities, community resources, case management, psychosocial and legal issues affecting patients and providers.
• Appropriately refers high-risk patients who would benefit from additional support.
• Serves as a patient advocate to enhance collaborative relationships for informed decision-making.
• Demonstrates knowledge of growth and development principles to provide age-appropriate care.
• Participates in interdisciplinary patient care rounds and conferences to review treatment goals and optimize resource utilization.
• Collaborates with clinical staff in developing and executing the plan of care and achieving goals.
• Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in planning patient care.

Requirements

• Graduate of an accredited program required for RN; BSN preferred or MSW/BSW with licensure as required by state regulations.
• Healthcare professional licensure required as Registered Nurse, or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations.
• Certification in Case Management is a plus.
• Two years of experience in a healthcare setting preferred.
• Prior experience in case management, utilization review, or discharge planning is preferred.
• Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
• Knowledge of Medicare benefits and insurance processes and contracts.
• Knowledge of accreditation standards and compliance requirements.
• Ability to demonstrate critical thinking, appropriate prioritization, and time management skills.
• Basic computer skills with working knowledge of Microsoft Office, word-processing, and spreadsheet software.
• Excellent interpersonal, verbal, and written communication skills.

Nice-to-haves

• Certification in Case Management is a plus.