Case Manager, RN

4 weeks ago

Gardena, United States Memorial Hospital of Gardena Full time
Job DescriptionJob Description

We’re Here for Our Communities.

With four hospitals in Los Angeles, California, we are focused on providing the care and service our communities deserve – including 24/7 emergency care.

Our staff, physicians and corporate leaders share a commitment to empower those in our communities to live the healthiest lives possible. Our patients are a diverse population living in underserved areas – individuals and families who come to us for quality care delivered with compassion. We believe every individual deserves just that.

We understand the impact we have on our neighbors and our potential to improve the overall health of the communities we serve. In a recent survey of employees across our Pipeline Health organization, employees told us that the work they do is meaningful to them. Survey respondents gave this statement an average score of 4.6 on a scale of 1-5, with 5 being “strongly agree.”

Inside our hospitals, our dedicated teams enjoy a family-like work environment as we serve our patients together. Employee engagement is a high priority as we are working to ensure that we have a work environment that employees enjoy, an environment where they can succeed.

Furthermore, our values define who we aspire to be. They guide us each and every day.

• Passion

• Innovation

• Compassion

• Integrity

• Resilience

Our Pipeline Health family of hospitals includes:

• Memorial Hospital of Gardena (CA)

• Coast Plaza Hospital (Norwalk, CA)

• Community Hospital of Huntington Park (CA)

• East Los Angeles Doctors Hospital (CA)

Each of our Pipeline hospitals is proud to boast a number of awards and accreditations for critical services. Working together, our Los Angeles hospitals have created a successful Patient Hub – a transfer center that moves eligible patients from other hospitals to available beds in our hospitals for quality care.

Job Summary:
The RN Case Manager (CM) performs a wide variety of tasks and functions. These include utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient patient progression, and payment for the services provided.

  • Serves as a liaison between the designated Avanti Hospital and payers to ensure financial coverage for the patient.
  • Coordinates resources and services for the patient/family in response to individual needs and fiscal responsibilities.
  • Works with the multidisciplinary team to ensure coordination of patient care and wise utilization of resources.
  • Documents case management activities in the patient record and in the required information system.
  • The RN CM reports to the Director/Manager of the department.

Essential Job Duties:

  • Applies appropriate clinical knowledge in order to identify patient needs and effectively communicate medical necessity and treatment plan to payers.
  • Reviews concurrently and retrospectively all inpatients for appropriateness of admission, level of care, and length of stay utilizing InterQual criteria.
  • Collaborates with the multidisciplinary team to develop, coordinate, implement and evaluate patient care.
  • Identifies and anticipates discharge needs and collaborates with the multidisciplinary team to ensure that each patient’s discharge needs are assessed, planned for, and addressed in a timely manner.
  • Educates and collaborates with the multidisciplinary team including physicians and patients/families regarding utilization issues, documentation of medical necessity, discharge options, and community resources.
  • Anticipates barriers to efficient and effective patient progression by identifying clinical, operational, financial and social issues affecting patient outcomes and intervening to address these issues.
  • Estimates the expected length of stay (ELOS) based on the knowledge of patient cases and interactions with the interdisciplinary team. Communicates expected discharges to the unit charge nurse, patient unit and family.
  • Identifies patients at risk for extended lengths of stay, readmission, and complex discharge needs.
  • Identifies and documents Avoidable Days using the data to address opportunities for improvement.
  • Prevents denials and disputes by communicating with payers and documenting relevant information.
  • Promotes prudent utilization of all resources (fiscal, human, environmental, equipment, and services) by evaluating resources available to the patient and balancing cost and quality to assure optimal clinical and financial outcomes.

Behavioral Standards:

  • Exhibits customer and service-oriented behaviors in everyday work interactions.
  • Demonstrates a courteous and respectful attitude to internal workforce and external customers.

Communication/Knowledge:

  • Time management and priority setting skills.
  • Must have the ability to manage multiple complex activities with tight deadlines.
  • Ability to design, develop, and implement programs and care coordination with initiative and creativity.
  • Skilled in working with a wide range of personalities and utilizes sound judgment in working with all members of the team, patients/families, and payer representatives.
  • Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal patient care outcomes.
  • Professional dress and demeanor.
  • Able to remain poised under stress.
  • Able to use IT systems in an accurate and proficient manner.

Collaboration/Teamwork:

  • Contributes toward effective, positive working relationships with internal and external colleagues.
  • Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.
  • Education/Experience:
  • Bachelor’s degree in nursing preferred, Master prepared a plus.
  • Minimum of 2-3 years in Case Management Acute Care setting

Licensure/Certifications:

  • Current RN licensed in good standing by the California Board of Nursing
  • Current BLS for Health Care Provider card.
  • Accredited Case Manager (ACM) or Certified Cas

  • Case Manager

    1 week ago

    Gardena, United States InsideHigherEd Full time

    Job no: 494417Work type: RegularLocation: HybridCategories: SalariedTitle: Case ManagerDepartment: Dean of Faculty's OfficeDuration: 12 months Job SummaryIn compliance with the Americans with Disabilities act as amended in 2008, Section 504 of the rehabilitation act of 1973 and the Fair Housing Act, the Case Manager coordinates student accommodations and...

  • Case Manager, RN

    4 weeks ago

    Gardena, United States Memorial Hospital of Gardena Full time

    Job DescriptionJob DescriptionWe’re Here for Our Communities. With four hospitals in Los Angeles, California, we are focused on providing the care and service our communities deserve – including 24/7 emergency care. Our staff, physicians and corporate leaders share a commitment to empower those in our communities to live the healthiest lives possible....

  • Home Health Rn in Gardena

    4 weeks ago

    Gardena, United States Agape Home Health Services, Inc. Full time

    **Title**: - Home Health Registered Nurse **Responsibilities**: - Performs initial and follow-up assessments including vital signs and medication review - Initiates the plan of care and makes necessary revisions as patient status and needs change - Assesses patients’ condition during every visit and put your observations into chart - Provides skilled...

  • Psychiatry

    1 week ago

    Gardena, United States Valor Healthcare Full time

    Psychiatry physician employment in California : DescriptionOur mission is simple: to provide quality healthcare to America's veterans through our healing focus, indebted hearts, and tireless resolve.About UsValor Healthcare operates more than 50 VA Community Based Outpatient Clinics (CBOCs) in the United States as a contractor for the U.S. Department of...

  • Psychiatry

    2 weeks ago

    Gardena, United States Valor Healthcare Full time

    Psychiatry physician job in California : DescriptionOur mission is simple: to provide quality healthcare to America's veterans through our healing focus, indebted hearts, and tireless resolve.About UsValor Healthcare operates more than 50 VA Community Based Outpatient Clinics (CBOCs) in the United States as a contractor for the U.S. Department of Veterans...

  • Director of Purchasing

    3 weeks ago

    Gardena, United States Interplace Full time

    Employment Requirements: must have 10 years of international commodity procurement experience The Director of Purchasing directs, administers, and coordinates a significant portion of the company’s overall purchasing spend. This role will lead the activities of two personnel engaged in supply chain management, supplier partnership, development, and...

  • RN Clinical Staff Med/Surg Tele 5th Floor Full Time Days

    2 weeks ago

    Gardena, United States Martin Luther King, Jr. Community Hospital Careers Full time

    If you are interested please apply online and send your resume to jcardenas@mlkch.org POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient care. Reporting to the Clinical Unit Supervisor of Telemetry, the...

  • Supervisor - RN Clinical Coordinator - Telemetry - Full Time

    5 days ago

    Gardena, CA, United States Martin Luther King, Jr. Community Hospital Full time

    If you are interested please apply online send your resume to jcardenas@mlkch.The Clinical Unit Supevisor is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of Medical-Surgical and Telemetry Nurisng care patient care. Reporting to the Nurse Manager of Medical...

  • REGISTERED NURSE RN

    3 weeks ago

    Gardena, CA 90248, USA, United States Kindred Healthcare Full time

    $15,000 Sign on BonusScionHealth is committed to a culture of service excellence as demonstrated by our employees' adherence to the service excellence principles of Pride, Teamwork, Compassion, Integrity, Respect, Fun, Professionalism, and Responsibility.As our most acute level of care, our specialty hospitals offer the same critical care patients receive in...

  • Clinical Research Associate I

    2 weeks ago

    Gardena, United States CEDARS-SINAI Full time

    Job Description The Smidt Heart Institute reflects Cedars-Sinai's steadfast dedication to heart disease and research innovation giving patients access to the highest level of care. Year after year, thousands of people trust their hearts to Smidt Heart Institute at Cedars-Sinai. Our cardiologists, cardiac surgeons and specialized care teams treat the full...

  • Registered Nurse Ii- Er/pt/days

    5 days ago

    Gardena, United States Memorial Hospital of Gardena Full time

    **Job Title: Registered Nurse II** **Base Rate: $43.41- $60.79** - 12 hr. shifts - overtime is paid after 8 hours, resulting in an average rate of $50.65 - $70.92_ **Sign-on/Retention Bonus: $10,000 /Full Time Only** **We’re Here for Our Communities.** With hospitals in Los Angeles, California we are focused on providing the care and service our...

  • BI Developer

    1 week ago

    Gardena, United States Bank of Hope Full time

    Collaborate with SMEs and other team members to gather analytics requirements and articulate Perform data profiling to identify and understand Design and develop Reporting solutions using the Bank’s Data Warehouse and BI (Reporting) environments following all Prepare test plans and test cases for functional and data testing - perform testing of analytics...

  • Registered Nurse- ER/PT/Days

    6 days ago

    Gardena, United States Pipeline Health System, LLC Full time

    Job Title: Registered NurseBase Rate: $43.41- $60.79 (ER, ICU) 12 hr. shifts- overtime is paid after 8 hours, resulting in an average rate of $50.65 - $70.92 Sign-on/Retention Bonus: $10,000 /Full Time OnlyWe're Here for Our Communities. With hospitals in Los Angeles, California we are focused on providing the care and service our communities deserve. Our...

  • RN Clinical Unit Supervisor Med Surg/Tele

    5 days ago

    Gardena, CA, United States Martin Luther King, Jr. Community Hospital Full time

    If you are interested please apply online send your resume to jcardenas@mlkch.org POSITION SUMMARY The Clinical Unit Supevisor is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of Medical-Surgical and Telemetry Nurisng care patient care. Reporting to the Nurse...

  • Registered Nurse II- ER/PT/Days

    5 days ago

    Gardena, United States Memorial Hospital of Gardena Full time

    Job DescriptionJob DescriptionJob Title: Registered Nurse IIBase Rate: $43.41- $60.79 12 hr. shifts- overtime is paid after 8 hours, resulting in an average rate of $50.65 - $70.92Sign-on/Retention Bonus: $10,000 /Full Time OnlyWe’re Here for Our Communities.With hospitals in Los Angeles, California we are focused on providing the care and service our...

  • ABA Technician

    4 weeks ago

    Gardena, United States Asteri Behavioral Treatment Center Full time

    Job DescriptionJob DescriptionSalary: $20-$25Job Overview:The ABA Behavioral Interventionist / Therapist is responsible for implementing Applied Behavior Analysis (ABA) interventions and providing direct one-on-one therapy to individuals with autism or other developmental disabilities. This role is crucial in assisting clients in acquiring new skills,...

  • WOUND CARE COORDINATOR FULL TIME

    6 days ago

    Gardena, CA 90248, USA, United States Kindred Healthcare Full time

    $20,000 Sign On BonusScionHealth is committed to a culture of service excellence as demonstrated by our employees' adherence to the service excellence principles of Pride, Teamwork, Compassion, Integrity, Respect, Fun, Professionalism, and Responsibility.As our most acute level of care, our specialty hospitals offer the same critical care patients receive in...

  • Physiatrist Contractor

    7 days ago

    Gardena, CA, United States Concentra Full time

    Overview:Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process.Concentra, one of the largest health care companies in the nation, is looking for a Physiatrist / Physical Medicine and Rehabilitation...

  • REGISTERED NURSE- ER/PT/DAYS

    4 days ago

    Gardena, CA 90248, USA, United States Pipeline Health System, LLC Full time

    Job Title: Registered NurseBase Rate: $43.41- $60.79 (ER, ICU)12 hr. shifts- overtime is paid after 8 hours, resulting in an average rate of $50.65 - $70.92Sign-on/Retention Bonus: $10,000 /Full Time OnlyWe're Here for Our Communities.With hospitals in Los Angeles, California we are focused on providing the care and service our communities deserve. Our...