RN Case Manager

$106,288 - $165,589/Yr

Community Memorial Health System - Ventura, CA

Part-time,Full-time - Entry Level

Ventura, CA

Hospitals

About the position

The RN Case Manager (RN CM) II plays a crucial role in coordinating patient care by collaborating with healthcare teams, patients, and families to develop discharge plans and arrange necessary post-acute care services. This position ensures that patient care meets established criteria and involves educating patients and families about available resources and care transitions.

Responsibilities

• Acts as liaison between physicians, nursing, other hospital departments, community agencies, health plans, patients and families.
• Conducts discharge and transitional care planning.
• Involves and educates patients and families regarding discharge planning and community resources.
• Collaborates with appropriate community resources on behalf of patients.
• Reports quality of care issues according to policies and procedures.
• Reports suspected or actual abuse.
• Participates in Process Improvement activities.
• Works independently and exercises sound judgment in interactions with physicians, payers, patients and families.
• Demonstrates strong organizational and time management skills, prioritizing multiple tasks and role components.
• Applies approved clinical criteria to monitor admissions and continued stays and documents findings based on Department standards.
• Pursues authorizations for acute stays and potential needs from third party payers.
• Monitors length of stay (LOS) and ancillary resources on an ongoing basis, reporting potential delays to physicians.
• Understands and acts in compliance with Medicare regulations.
• Facilitates patient's right to appeal.
• Assesses for and facilitates transitions of care, maintaining communication with post-acute providers.
• Utilizes critical thinking skills and judgment to evaluate the clinical and psychosocial condition of all patients.
• Ensures that patient evaluations are complete and reflect a comprehensive evaluation of the patient.
• Assures that Discharge plan is in place in a timely fashion.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency.
• Serves as a preceptor, mentor and resource to less experienced staff.
• Performs other duties as assigned.

Requirements

• Associate Degree in Nursing (ADN) or higher
• Current CA Registered Nurse (RN) License
• Current Basic Life Support (BLS) Certification
• One (1) year of case management experience
• One (1) year of acute care experience

Nice-to-haves

• Bachelors of Science in Nursing (BSN)
• Bilingual in Spanish
• Experience in Case Management and strong discharge planning skills
• Previous experience with InterQual
• Previous experience with Allscripts and Meditech

Benefits

• Competitive Pay
• Shift Differentials
• In-House Registry Rates
• Fidelity 403(b) Retirement Plan
• Paid Time Off
• Medical (EPO/PPO), Dental, & Vision Insurance Coverage
• Voluntary Worksite Benefits
• Employee Assistance Program Available 24/7 (EAP)
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF)
• Recognition programs
• Employee service recognition events
• Home, Retail, Travel & Entertainment Discounts
• National Hospital Week and National Nurses Week celebrations