Case Manager, RN- Pre Access
3 weeks ago
Find out exactly what skills, experience, and qualifications you will need to succeed in this role before applying below.
1 Openings
Pay Range: CASE MANAGER, RN - $46.50 to $68.68
Job Summary
The RN Case Manager-Pre Access is responsible for screening, coordinating, and facilitating admission review of all acute patients. Working collaboratively with all interdisciplinary staff, facilitates admission and transfer of patients, ensure that each patient is admitted meeting established medical guidelines in collaboration with credentialed medical staff, assist with the coordination of patient transfers into the hospital, and communicates all requested and questionable admissions/transfers to the Director of Case Management , and/or Physician Advisor.
Licensure and Certification:
Current CA RN license
Current BLS provider card
Case Management certification preferred
Education:
Diploma, AA, BS in Nursing
MS in Nursing preferred
Experience:
Two years as a Case Manager in an acute care setting or five years recent acute care nursing experience preferred.
Experience in Critical Care setting preferred
Demonstrates strong interpersonal skills, leadership ability, negotiation skills, and knowledge of hospital operations. General knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential.
Advanced experience utilizing InterQual required.
Knowledge and Skills:
Develops, maintains, and models professional, objective and value-oriented interpersonal skills. Continuously promotes a patient-centered philosophy.
Maintains positive and proactive communication with patients, families, staff members, and physicians.
Fosters team-building relationships
Excellent organizational skills and the ability to problem solve are essential
Strong interpersonal skills, leadership, negotiation skills, good leadership talent
Knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential
Knowledge of State and Federal regulations; e.g. EMTALA, Medi-Cal, HMOs, etc.
Understanding of Medicare, Medi-Cal and other Third Party Payer regulations
Understanding of current utilization/quality management principles, techniques and procedures
Knowledge of current utilization/quality management principles, techniques and procedures
Physical Demands – Patient Care:
Continuous standing/walking and occasional/intermittent sitting.
Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and shoulder level to handle/operate medical equipment/devices.
Frequent reaching above shoulder level and overhead.
Frequent forward bending, twisting, squatting and kneeling; occasional climbing.
Occasional repositioning and transferring patients weighing up to 200 pounds between bed, chair, and gurney.
Occasional lifting and carrying equipment weighing up to 25 pounds.
Occasional/intermittent pushing of gurneys, wheelchairs, bed and other medical equipment over tiled and carpeted surfaces.
Continuous use of near vision to read medical equipment such as monitoring devices and reading documents and computer screens; hearing and verbal communication to interact with patients, co-workers, and other customers.
Key for Physical Demands
Continuous
66 to 100% of the time
Frequent
33 to 65% of the time
Occasional
0 to 32% of the time
#INDHP
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