Sutter Health
Case Manager/RN
Sutter Health, San Francisco, California, United States, 94199
Organization:CPMC-California Pacific Med Center - Mission BernalPosition Overview:The RN Case Manager is responsible for Care Coordination, Care Transitions, Discharge Planning, and Utilization Management throughout the acute care patient experience. The RN Case Manager works in collaboration with the Physician, Medical Social Worker, and bedside RN to assure the timely movement of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. Oversees the management of acute patient populations across the care continuum with the primary focus to provide coordinated, timely, and integrated care. The RN Case Manager reports to either the Supervisor, Manager, or Director of Care Coordination in each facility. The RN Case Manager has frequent contact with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third-party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources.Job Description :EDUCATIONEquivalent experience will be accepted in lieu of the required degree or diploma.
Bachelor's: BS in one of the following: Nursing or Health Administration.
Master's: Master in nursing, case management, or related field.
CERTIFICATION & LICENSURE
RN-Registered Nurse of California
CCM-Certified Case Manager (optional)
PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:
Minimum of three (3) years in acute medical/surgical/ED/ or critical care nursing area required. Masters of Nursing in Case Management in lieu of three (3) years in acute medical/surgical/ED/ or critical care nursing area may be considered for employment at director's discretion.
Previous Case Management experience preferred.
Experience utilizing electronic InteQrual or other standardized criteria strongly preferred.
Experience with clinical assessment for patients with complex medical, emotional, and social needs.
Experience using an electronic medical record system.
Experience and knowledge with MIDAS preferred.
SKILLS AND KNOWLEDGE
Excellent interpersonal communication and negotiation skills.
A 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.
Some awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS preferred.
Post-acute levels of care such as Home Health, Hospice, AIM, and Palliative Care. SNF, LTAC, B&C, Sub-acute, Acute rehab.
General Knowledge of coding and DRG assignment process preferred.
Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses, and other ancillary partners.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
Demonstrates commitment to service excellence in all patient, family, and employee interactions and in performing all job responsibilities.
Functions in a manner to promote quality patient care and assure a positive patient experience.
Excellent verbal and written communication skills.
Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
Intermediate computer skills.
Ability to promote teamwork and to effectively function in teams.
Ability to interact effectively with key internal and external constituents using collaboration and customer service skills that promote excellence in the patient experience.Job Shift:
DaysSchedule:
Part TimeShift Hours:
8Days of the Week:
VariableWeekend Requirements:
Every other WeekendBenefits:
YesUnions:
YesPosition Status:
Non-ExemptWeekly Hours:
32Employee Status:
Limited Term (Fixed Term)Number of Openings:
1Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.Pay Range is $77.30 to $104.61 / hourThe salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.
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Bachelor's: BS in one of the following: Nursing or Health Administration.
Master's: Master in nursing, case management, or related field.
CERTIFICATION & LICENSURE
RN-Registered Nurse of California
CCM-Certified Case Manager (optional)
PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:
Minimum of three (3) years in acute medical/surgical/ED/ or critical care nursing area required. Masters of Nursing in Case Management in lieu of three (3) years in acute medical/surgical/ED/ or critical care nursing area may be considered for employment at director's discretion.
Previous Case Management experience preferred.
Experience utilizing electronic InteQrual or other standardized criteria strongly preferred.
Experience with clinical assessment for patients with complex medical, emotional, and social needs.
Experience using an electronic medical record system.
Experience and knowledge with MIDAS preferred.
SKILLS AND KNOWLEDGE
Excellent interpersonal communication and negotiation skills.
A 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.
Some awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS preferred.
Post-acute levels of care such as Home Health, Hospice, AIM, and Palliative Care. SNF, LTAC, B&C, Sub-acute, Acute rehab.
General Knowledge of coding and DRG assignment process preferred.
Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses, and other ancillary partners.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
Demonstrates commitment to service excellence in all patient, family, and employee interactions and in performing all job responsibilities.
Functions in a manner to promote quality patient care and assure a positive patient experience.
Excellent verbal and written communication skills.
Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
Intermediate computer skills.
Ability to promote teamwork and to effectively function in teams.
Ability to interact effectively with key internal and external constituents using collaboration and customer service skills that promote excellence in the patient experience.Job Shift:
DaysSchedule:
Part TimeShift Hours:
8Days of the Week:
VariableWeekend Requirements:
Every other WeekendBenefits:
YesUnions:
YesPosition Status:
Non-ExemptWeekly Hours:
32Employee Status:
Limited Term (Fixed Term)Number of Openings:
1Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.Pay Range is $77.30 to $104.61 / hourThe salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.
#J-18808-Ljbffr