Case Manager- RN

2 months 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)

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 Case Manager

  • Travel Nurse RN

    4 weeks ago

    Gardena, CA, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Gardena, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 08/26/2024 Duration: 9 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...

  • Manager of Case Management-RN

    4 days ago

    Gardena, California, United States Memorial Hospital of Gardena Full time

    Job SummaryThe Manager of Case Management plays a pivotal role in the development and implementation of the case management program at Memorial Hospital of Gardena. Reporting to the Director, this individual is responsible for overseeing the case management staff, creating and enforcing policies and procedures, and coordinating care with other healthcare...

  • Manager of Case Management-RN

    3 days ago

    Gardena, California, United States Memorial Hospital of Gardena Full time

    Job SummaryThe Manager of Case Management plays a pivotal role in the development and implementation of the case management program at Memorial Hospital of Gardena. Reporting to the Director, this individual is responsible for overseeing the case management staff, creating and enforcing policies and procedures, and coordinating care with other healthcare...

  • Manager of Case Management-RN

    3 weeks ago

    Gardena, United States Pipeline Health Full time

    Job Title: Manager of Case Management Job Summary: The Manager of Case Management assists the Director with the overall development of the case management program and implements at the local level. This includes oversight of all case management staff, development and implementation of case management policies and procedures, and coordination of care...

  • Manager of Case Management-RN

    1 day ago

    Gardena, United States Memorial Hospital of Gardena Full time

    Job Title: Manager of Case ManagementIf you would like to know a bit more about this opportunity, or are considering applying, then please read the following job information.Job Summary:The Manager of Case Management assists the Director with the overall development of the case management program and implements at the local level. This includes oversight of...

  • Manager of Case Management-RN

    3 weeks ago

    Gardena, United States Pipeline Health System, LLC Full time

    Job Title: Manager of Case ManagementJob Summary: The Manager of Case Management assists the Director with the overall development of the case management program and implements at the local level. This includes oversight of all case management staff, development and implementation of case management policies and procedures, and coordination of care with...

  • Healthcare Case Manager RN

    20 minutes ago

    Gardena, California, United States Pipeline Health Full time

    Job SummaryPipeline Health is seeking a skilled RN Case Manager to join our team. As a RN Case Manager, you will play a critical role in ensuring the delivery of necessary services, efficient patient progression, and payment for the services provided.Key ResponsibilitiesServe as a liaison between Pipeline Health and payers to ensure financial coverage for...

  • Case Management Supervisor

    3 days ago

    Gardena, California, United States Pipeline Health Full time

    Job Title: Case Management Supervisor Job Overview: The Case Management Supervisor plays a pivotal role in supporting the Director in the strategic advancement of the case management initiative and its execution at the local level. This position entails the supervision of all case management personnel, the formulation and enforcement of case...

  • Case Management Supervisor

    3 days ago

    Gardena, California, United States Pipeline Health Full time

    Job Title: Case Management Supervisor Job Overview: The Case Management Supervisor plays a pivotal role in supporting the Director in the strategic advancement of the case management initiative, ensuring effective implementation at the local facility. This position encompasses the supervision of all case management personnel, the formulation and...

  • Case Management Supervisor

    3 days ago

    Gardena, California, United States Pipeline Health Full time

    Job Title: Case Management Supervisor Job Overview: The Case Management Supervisor plays a pivotal role in supporting the Director in the strategic development and execution of the case management framework at the local level. This position entails the supervision of all case management personnel, crafting and enforcing case management policies and...

  • Manager of Case Management

    1 month ago

    Gardena, United States Memorial Hospital of Gardena Full time

    Job DescriptionJob DescriptionJob Title: Manager of Case ManagementJob Summary:The Manager of Case Management assists the Director with the overall development of the case management program and implements at the local level. This includes oversight of all case management staff, development and implementation of case management policies and procedures, and...

  • RN Case Manager

    4 weeks ago

    Gardena, United States Platinum Healthcare Staffing Full time

    Job DescriptionJob DescriptionTRAVEL POSITION for an LTAC Organization Position Information:Coordinates management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall...

  • Case Management Travel Nurse RN Position

    11 hours ago

    Gardena, California, United States Advantis Medical Full time

    Advantis Medical is seeking a skilled travel nurse RN to fill a case management position.Job DetailsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelAbout the PositionThis travel nurse RN case management position offers a unique opportunity to work with a reputable healthcare organization.BenefitsCompetitive payGuaranteed hours401k retirement...

  • Mobile Case Manager RN

    1 week ago

    Gardena, California, United States TravelNurseSource Full time

    Position OverviewTravelNurseSource is collaborating with TRS Healthcare to identify a skilled Registered Nurse specializing in Case Management.Compensation DetailsThe weekly pay for this role is $2,591.Role ResponsibilitiesThe Registered Nurse will be responsible for integrating the organization's vision, values, mission, and critical objectives into their...

  • Travel Nurse RN

    4 weeks ago

    Gardena, United States Favorite Healthcare Staffing Full time

    At Favorite Healthcare Staffing, we aspire to learn what thrills you about being a healthcare professional. Our exceptional recruiters thrive on the challenge of discovering the perfect position for you. From day one, your dedicated recruiter has your back as you search for your next adventure. Apply today to join the Favorite Family! Favorite Healthcare...

  • Travel Registered Nurse RN Care Management

    4 weeks ago

    Gardena, CA, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Gardena, California. Specialty: Case Management ~ Shift: 8 hours, days ~ Employment Type: Travel TotalMed Case Management Staffing Job ID #1594779. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with...

  • Registered Nurse Case Management Specialist

    1 week ago

    Gardena, California, United States Compunnel Full time

    Position Overview: RN Case ManagerWe are seeking a qualified and experienced Registered Nurse Case Manager to provide exceptional care management services. This role is crucial in ensuring patients receive the necessary support and resources throughout their healthcare journey.Contract Details:This is a contract position with a duration of 13 weeks.Work...

  • Registered Nurse

    1 week ago

    Gardena, California, United States Assured Nursing Full time

    Position Overview:Assured Nursing is actively seeking a skilled travel nurse RN specializing in Case Management for an exciting opportunity.Job Specifications:Specialty: Case ManagementDiscipline: RNEmployment Type: TravelWork Schedule: 8-hour shifts, daytimeJob Responsibilities:The selected candidate will be responsible for providing high-quality patient...

  • Travel Nurse RN

    4 weeks ago

    Gardena, United States MedPro Healthcare Staffing Full time

    MedPro Healthcare Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Gardena, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 08/26/2024 Duration: 13 weeks 36 hours per week Shift: 8 hours, days Employment Type: Travel MedPro Healthcare Staffing, a Joint Commission-certified...

  • Travel Nurse RN

    4 weeks ago

    Gardena, United States MedPro Healthcare Staffing Remote Work Freelance Full time

    MedPro Healthcare Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Gardena, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: 08/26/2024Duration: 13 weeks36 hours per weekShift: 8 hours, daysEmployment Type: TravelMedPro Healthcare Staffing, a Joint Commission-certified staffing...