Under general supervision, the Care Manager is responsible for facilitating the patient's hospitalization from pre-admission through discharge. The Care Manager coordinates with physicians, nurses, social workers and other healthcare providers to expedite medically appropriate cost effective care. The care manager applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning. The case manager will communicate with administration and the healthcare team as needed to facilitate patient care.
Current Registered Nurse (RN) license issued by the State of California.
A professional Degree in related Healthcare discipline.
BART or BLS at time of hire with commitment to get BART w/in 6 months of hire date.
Prior case management experience in large,acute care Hospital.
Utilization review/discharge planning experience.
Proficiency in Information Systems,databases, and computer programs including MS Office: Word, Excel, Outlook, PowerPoint, etc.
Fast and accurate typing and data entry skills.
Knowledge of payer industry, resource management, reimbursement, and evidence-based clinical practice is essential.
Must possess strong interpersonal skills,leadership, negotiation skills, and knowledge of hospital operations.
Skilled in conflict management and resolution.
Three to five (3-5) years clinical experience or in an acute care setting.
Previous Supervisory/Management experience
BSN - MSN.
ACM and/or CCM certificate.
Experience with Epic, Midas, ECIN, Interqual.
Must be able to work various hours and locations based on business needs.
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