Registered Nurse - Case Manager

Duties

• Perform care coordination and discharge planning for patients.
• Organize and participate in family meetings.
• Develop and implement treatment plans.
• Coordinate with interdisciplinary teams for comprehensive patient care.
• Arrange Durable Medical Equipment (DME), Skilled Nursing Facility (SNF), and ambulance transport independently.
• Utilize computerized documentation systems effectively.
• Float to the Laguna Facility as needed.
• Participate in weekend rotations as required.

Skills

• Acute Hospital Case Management/Utilization Review
• Appeals and Denials
• Care Coordination
• Disability Case Management
• Discharge Planning
• Disease Management
• Needs Assessment/Order DME
• Plan of Care
• Worker’s Comp Case Management
• Regulatory Knowledge: CMS, Department of Health, DRG, HIPAA, OSHA, The Joint Commission
• Experience with HMOs, IPAs, and related healthcare systems
• Knowledge of adoption/foster care, drug/alcohol abuse treatment, mental health crisis management, and protective services processes

Experience

• 2 years of acute medical Care Manager experience in care coordination.
• Travel experience is required.
• Experience in Trauma Level I and II is preferred.
• Experience in Emergency Department, ICU, and Surgical Services is preferred.
• Experience in teaching and community hospitals is beneficial.
• Proficiency with the Epic charting system is required.