Registered Nurse Case Manager (RN)

Shift: Days

Job Type: Full Time

Hours: 0800-1630

Schedule: 10 shifts per two pay period. Rotating weekends required.

Up to $25,000 Sign-On bonus based on experience

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions.

1. Utilization Management supporting medical necessity and denial prevention.
2. Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction.
3. Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care.
4. Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy.
5. Education provided to physicians, patients, families and caregivers.
6. Accurate medical necessity screening and submission for Physician Advisor review.
7. Timely complete and concise documentation in Case Management system.
8. Maintenance of accurate patient demographic and insurance information.
9. Identification and documentation of potentially avoidable days.
10. Identification and reporting over and underutilization.
11. Other duties as assigned.

• CA Registered Nurse license
• At least two years acute hospital patient care experience
• BSN preferred
• Accredited Case Manager (ACM) preferred
• Acute hospital case management experience preferred
• Required skills include demonstrated organizational skills
• Excellent verbal and written communication skills