Job Title: Case Manager RN
Profession: Registered Nurse
Specialty: Case Manager
Duration: 13 weeks
Shift: Day
Hours per Shift: 8 hours
Experience: Minimum 2 years of relevant experience
License: RN - Registered Nurse of California
Certifications: Bachelor’s in Nursing preferred
Must-Have:
Graduate of an accredited school of nursing
2 years recent relevant experience
Broad knowledge base of health care delivery and case management within a managed care environment
Comprehensive knowledge of Utilization Review, levels of care, and observation status
Working knowledge of laws, regulations, and professional standards affecting case management practice
Ability to effectively communicate and promote collaboration between patients, families, physicians, nurses, and other partners
Strong verbal and written communication skills
Excellent time management skills
Ability to promote teamwork and function effectively in teams
Description:
The position requires a graduate of an accredited nursing school.
A Bachelor’s in Nursing is preferred.
A minimum of 2 years of recent relevant experience is required.
Candidates should have a broad knowledge base of healthcare delivery and case management in a managed care environment.
Comprehensive knowledge of Utilization Review, levels of care, and observation status is essential.
The role requires an understanding of healthcare reimbursement systems, including HMO and PPO models.
Candidates should possess knowledge of laws, regulations, and professional standards affecting case management practice.
A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements is necessary.
Understanding of coding and DRG assignment processes is preferred.
The candidate must effectively communicate with various stakeholders, including patients and families.
A commitment to service excellence in all interactions is required.
The role involves promoting quality patient care and ensuring a positive patient experience.
Candidates must display strong negotiation skills and an ability to manage time effectively in a high-volume environment.
Intermediate computer and technology skills are necessary.
The ability to interact effectively using collaboration and customer service skills to promote excellence in patient experience is important.