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RN Care Manager, Care Coordination
3 months ago
Orange, California
Work Shift
Day - 08hrs (United States of America)
Why CHOC?
At CHOC, we strive to be the leading destination of children's health by providing exceptional and innovative care. We are responsible for the overall health of our community's pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine. CHOC's compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals. Apply now to see where your career at CHOC can take you.
Job Summary
The RN Care Manager is responsible for one of the following: utilization review of all inpatient services; the delivery of care coordination services for patients admitted to an inpatient bed or in the specialty clinics. Assumes a leadership role for the primary role assigned to the interdisciplinary team to achieve optimal clinical and resource outcomes. Provides oversight for care teams which includes the care manager assistant and other members responsible for assisting patients and families with navigating the pediatric system of care. Is involved in the planning and delivery of patient and family-centered care through a collaborative process including the patient and family, nurses, social workers, physicians, other practitioners, caregivers, and the community. Also responsible for securing authorizations and promoting the efficient use of healthcare resources. Provides a full range of nursing care and assists in meeting the comprehensive care needs of the patients and their families.
Pay Range
Minimum $61.00 Midpoint $61.00 Maximum $62.00
Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.
Experience
• Required: Minimum two (2) years of nursing experience in a pediatric care or ambulatory setting.
• Preferred: Three (3) years of nursing experience in an emergency department and/or case management, care coordination, or transition of care. Previous pediatric experience and/or management and/or charge nurse role acceptable.
Education
• Required: Graduation with a bachelor's degree from an accredited University.
• Preferred: Bachelor or master's degree in Nursing or a health-related field from an accredited University.
Training
• Required: None required.
• Preferred: Certification in Case Management
Specialized Skills
• Required: Ability to work effectively under pressure due to changing priorities, interruptions, high/low census, payor demands and
discharge planning demands. Excellent interpersonal communication, including conflict resolution, problem-solving, and negotiation skills.
Clinical knowledge of multiple age groups, medical illness, and treatment plans according to disease process, diagnosis and anticipated LOS.
Strong organizational and time management skills, as evidenced by the capacity to multi-task and prioritize. Ability to work independently and
exercise sound judgment in interactions with physicians, payers, patients, and their families. Demonstrates the knowledge and skills
necessary to communicate with third-party payers to obtain authorization for the appropriate treatment setting for patients requiring medical,
psych and chemical dependency treatment. Must be proficient in required competencies upon completion of orientation and maintain annual
departmental competency requirements. Ability to work collaboratively regardless of social, economic, and cultural backgrounds. Computer
knowledge to include skills in using Microsoft Office e.g., Excel, Word, PowerPoint, Access, etc.
• Preferred: Knowledge of CCS/Medi-Cal regulations and requirements. Knowledge of third-party payor requirements in order to optimize
reimbursement. Ability to apply severity of illness/ intensity of service pediatric criteria to information extracted from clinical documentation.
Bilingual in English and Spanish.
Licensure
• Required: Registered Nurse (RN) - CA; Basic Life Support (BLS); Pediatric Emergency Assessment & Stabilization (PEARS) upon hire or must be obtained within six (6) months of hire with valid Pediatric Advanced Life Support (PALS)
• Preferred: Certified Pediatric Nurse (CPN); Certified Case Manager (CCM); Commission for Case Manager Certification (CCMC).
Work Environments - Functional Demand:
Light - Moderate energy level Lift and carry 25-35 lbs. Push/pull 50-100 lbs. (ie. empty bed, stretcher).
Physical Activity Requirements:
Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation
Physical Activity Lifting
Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Occasional 0-35%
Sensory Requirements:
Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision
Environment Requirements:
Airborn Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations
Non-Discrimination Statement:
CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws.
We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn't align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.
If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.
