Care Manager
4 weeks ago
Description:
This is a Full-Time (72 hours per pay period) with DAY shift hours on variable days of the week including holidays and weekends.
This position helps cover all 5 Scripps Hospitals’ (Encinitas, La Jolla, Torrey Pines, Hillcrest, and Chula Vista) and our Central Transfer Center located in La Jolla.
We invite you to join our Care Manager, Systemwide Resource team.
Our Scripps System-wide Resource Services (SSRS) department supports the entire Scripps Health system. As a member of the float team, you can fill vital roles on assignments throughout the system to provide critical coverage for employee’s leave of absences, sick calls, and peak service demands while gaining experience in a variety of environments.
This is the ideal role for a registered nurse who is self-motivated, results-oriented, and able to effectively work both autonomously, and within a team environment. You will be joining one of the best healthcare organizations in San Diego, and work with a highly engaged inter-disciplinary team helping drive patient length of stay.
As a Care Manager for the Systemwide Resource team, you will…
Screen patients in their assigned caseload to identify those that are medically vulnerable, who may have needs that may be addressed at another location; or within contracted programs/vendors specific to their needs/health plan.
Coordinates with the health care team and the patient/family to address issues that may impact their care, and to develop a transition plan of care based on the patients' needs.
Qualifications:
Preferred Education/Experience/Specialized Skills/Certification:
Bachelor of Science in Nursing (BSN) highly desired.
Case management certification highly preferred.
Demonstrate knowledge of utilization management including experience managing prior-authorization and concurrent review.
Knowledge of Medicare and Commercial health plans.
3+ years of managed care and/or case management experience.
Required Education/Experience/Specialized Skills:
2+ years clinical experience
1-2 years of inpatient case management experience
Excellent verbal and written communication (including documentation) skills demonstrated by completing the required forms and the ability to work effectively with individuals and or teams across disciplines.
Ability to independently utilize critical thinking skills, nursing judgement and decision-making skills.
Ability to prioritize, plan, and handle multiple tasks/demands simultaneously as evidence by capacity of open cased, active care plan rate and the ability to handle multiple tasks.
Ability to read, analyze and interpret information in medical records, and health plan documents.
Demonstrates knowledge in Microsoft Office applications including Outlook, Word, and Excel
Required Certification/Registration:
Current California RN License.
Current BLS for Health Care Provider from American Heart Association.
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