Sutter Health
Case Manager II, Registered Nurse
Sutter Health, San Francisco, California, United States, 94199
We are so glad you are interested in joining Sutter Health!Organization:
Bay AdministrationPosition Overview:
Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self-determination while coordinating in a timely and integrated fashion. He/She collaborates 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. If assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions.JOB ACCOUNTABILITIES:Patient Initial and Continued Assessment: Reviews initial physician admission care plan, gathers additional medical, psychosocial, and financial information from the patient/family interview, medical record assessment, physicians, and other health care providers. Determines moderate or high risk level for readmission. Conducts a screening for ancillary supportive services, including but not limited to Palliative Care Services’ needs.Utilization Management: Reviews medical record to ensure patient continues to meet level of care (LOC) requirements and that chart documentation supports LOC determination and assignment.Care Coordination/ Care Transitions: Formulates a transition plan after reviewing available/appropriate care options and obtaining input, and collaborating with the patient/family and physician, health care team, payers, and community based support services.Actively participates in ongoing department operations: Identifies new systems, processes, protocols and/or methods to improve practices.Uses effective interpersonal and communication skills to promote customer service with internal and external customers: Develops and maintains positive, productive, and professional relationships with the healthcare team and representatives of community agencies.EDUCATION:
Graduate of an accredited school of nursingCERTIFICATION & LICENSURE:
RN-Registered Nurse of California Upon HireTYPICAL EXPERIENCE:
2 years recent relevant experience.SKILLS AND KNOWLEDGE:
A broad knowledge base of health care delivery and case management within a managed care environment.PHYSICAL ACTIVITIES AND REQUIREMENTS:
See required physical demands, mental components, visual activities & working conditions at the following link:
Job RequirementsJob Shift:
DaysSchedule:
Part TimeShift Hours:
8Days of the Week:
VariableWeekend Requirements:
As NeededBenefits:
YesUnions:
NoPosition Status:
Non-ExemptWeekly Hours:
36Employee Status:
RegularNumber of Openings:
1Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.Pay Range is $82.95 to $109.48 / hour. The 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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Bay AdministrationPosition Overview:
Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self-determination while coordinating in a timely and integrated fashion. He/She collaborates 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. If assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions.JOB ACCOUNTABILITIES:Patient Initial and Continued Assessment: Reviews initial physician admission care plan, gathers additional medical, psychosocial, and financial information from the patient/family interview, medical record assessment, physicians, and other health care providers. Determines moderate or high risk level for readmission. Conducts a screening for ancillary supportive services, including but not limited to Palliative Care Services’ needs.Utilization Management: Reviews medical record to ensure patient continues to meet level of care (LOC) requirements and that chart documentation supports LOC determination and assignment.Care Coordination/ Care Transitions: Formulates a transition plan after reviewing available/appropriate care options and obtaining input, and collaborating with the patient/family and physician, health care team, payers, and community based support services.Actively participates in ongoing department operations: Identifies new systems, processes, protocols and/or methods to improve practices.Uses effective interpersonal and communication skills to promote customer service with internal and external customers: Develops and maintains positive, productive, and professional relationships with the healthcare team and representatives of community agencies.EDUCATION:
Graduate of an accredited school of nursingCERTIFICATION & LICENSURE:
RN-Registered Nurse of California Upon HireTYPICAL EXPERIENCE:
2 years recent relevant experience.SKILLS AND KNOWLEDGE:
A broad knowledge base of health care delivery and case management within a managed care environment.PHYSICAL ACTIVITIES AND REQUIREMENTS:
See required physical demands, mental components, visual activities & working conditions at the following link:
Job RequirementsJob Shift:
DaysSchedule:
Part TimeShift Hours:
8Days of the Week:
VariableWeekend Requirements:
As NeededBenefits:
YesUnions:
NoPosition Status:
Non-ExemptWeekly Hours:
36Employee Status:
RegularNumber of Openings:
1Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.Pay Range is $82.95 to $109.48 / hour. The 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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