Sharp HealthCare
RN Case Manager I - Sharp Memorial Hospital - FT - Days
Sharp HealthCare, San Diego, California, United States, 92189
Hours :
Shift Start Time:
8:30 AM Shift End Time:
5 PM AWS Hours Requirement:
8/80 - 8 Hour Shift Additional Shift Information: Weekend Requirements:
Every Other On-Call Required:
No Hourly Pay Range (Minimum - Midpoint - Maximum):
$54.400 - $67.470 - $80.540 The stated pay scale reflects the range as defined by the collective bargaining agreement between Sharp HealthCare and Sharp Professional Nurses Network, United Nurses Associations of California/Union of Health Care Professionals, NUHHCE, AFSME, AFL-CIO. Placement within the range is based on years of RN experience.
What You Will Do The RN CM I assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the appropriate setting and level of care. The position creates a balance between individual clinical needs with the efficient and cost-effective utilization of resources while promoting quality outcomes. This position requires critical thinking and advanced problem-solving and time management skills.
Required Qualifications
2 Years Recent acute care nursing experience, case management experience or equivalent experience in the healthcare setting. California Registered Nurse (RN) - CA Board of Registered Nursing - REQUIRED
Preferred Qualifications
Bachelor's Degree in Nursing or equivalent degree. Master's Degree Certified Case Manager (CCM) - Commission for Case Manager Certification - PREFERRED Accredited Case Manager (ACM) - American Case Management Association (ACMA) - PREFERRED
Essential Functions
Professional development: The RN CM I will actively participate in the performance-planning, competency and individual development planning process, and maintain current knowledge of case management, utilization management, and discharge planning, as specified by Sharp, federal, state, and private insurance guidelines. Core principles: The RN CM I will make timely referrals to ensure that the patient is receiving the appropriate care, in the appropriate setting and using the appropriate utilization standards as set by community and professional standards adopted by the medical staff. Organizational relationships: The RN CM I will work closely with the healthcare team in reaching unit, facility, and system/network organization goals including reductions in length of stay, decreasing denials, improvement of care transitions, and reduction in avoidable readmissions, improved patient experience, and other quality initiatives. Care coordination and discharge planning: Within 24 hours of admission, the RN CM I will interview/assess each patient/family for anticipated needs post hospitalization and ensure patient choice is obtained and documented in accordance with all state and federal regulatory requirements. Utilization review and utilization management: The RN CM I will conduct initial review at POE or within 24 hours of admission utilizing appropriate evidenced-based care guidelines software and document findings in ICM software (EMR).
Knowledge, Skills, and Abilities
PC, data management and analysis skills required (experience with MCG an asset). Excellent interpersonal skills, as demonstrated by the ability to work effectively with individuals and or teams, and across disciplines. Excellent communication and negotiation skills as demonstrated in oral and written forms. Ability to work in a collaborative partnership model with Social Workers and other members of the interdisciplinary team, both internal and external.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.
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8:30 AM Shift End Time:
5 PM AWS Hours Requirement:
8/80 - 8 Hour Shift Additional Shift Information: Weekend Requirements:
Every Other On-Call Required:
No Hourly Pay Range (Minimum - Midpoint - Maximum):
$54.400 - $67.470 - $80.540 The stated pay scale reflects the range as defined by the collective bargaining agreement between Sharp HealthCare and Sharp Professional Nurses Network, United Nurses Associations of California/Union of Health Care Professionals, NUHHCE, AFSME, AFL-CIO. Placement within the range is based on years of RN experience.
What You Will Do The RN CM I assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the appropriate setting and level of care. The position creates a balance between individual clinical needs with the efficient and cost-effective utilization of resources while promoting quality outcomes. This position requires critical thinking and advanced problem-solving and time management skills.
Required Qualifications
2 Years Recent acute care nursing experience, case management experience or equivalent experience in the healthcare setting. California Registered Nurse (RN) - CA Board of Registered Nursing - REQUIRED
Preferred Qualifications
Bachelor's Degree in Nursing or equivalent degree. Master's Degree Certified Case Manager (CCM) - Commission for Case Manager Certification - PREFERRED Accredited Case Manager (ACM) - American Case Management Association (ACMA) - PREFERRED
Essential Functions
Professional development: The RN CM I will actively participate in the performance-planning, competency and individual development planning process, and maintain current knowledge of case management, utilization management, and discharge planning, as specified by Sharp, federal, state, and private insurance guidelines. Core principles: The RN CM I will make timely referrals to ensure that the patient is receiving the appropriate care, in the appropriate setting and using the appropriate utilization standards as set by community and professional standards adopted by the medical staff. Organizational relationships: The RN CM I will work closely with the healthcare team in reaching unit, facility, and system/network organization goals including reductions in length of stay, decreasing denials, improvement of care transitions, and reduction in avoidable readmissions, improved patient experience, and other quality initiatives. Care coordination and discharge planning: Within 24 hours of admission, the RN CM I will interview/assess each patient/family for anticipated needs post hospitalization and ensure patient choice is obtained and documented in accordance with all state and federal regulatory requirements. Utilization review and utilization management: The RN CM I will conduct initial review at POE or within 24 hours of admission utilizing appropriate evidenced-based care guidelines software and document findings in ICM software (EMR).
Knowledge, Skills, and Abilities
PC, data management and analysis skills required (experience with MCG an asset). Excellent interpersonal skills, as demonstrated by the ability to work effectively with individuals and or teams, and across disciplines. Excellent communication and negotiation skills as demonstrated in oral and written forms. Ability to work in a collaborative partnership model with Social Workers and other members of the interdisciplinary team, both internal and external.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.
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