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RN Case Manager, Managed Care Referrals Specialist
2 months ago
We are seeking a highly skilled RN Case Manager to join our team at Sutter Health. As a key member of our healthcare team, you will play a critical role in coordinating the utilization management, resource management, discharge planning, post-acute care referrals, and care facilitation for our patients.
Key Responsibilities- Coordinate the utilization management, resource management, discharge planning, post-acute care referrals, and care facilitation for patients.
- Oversee the management of acute patient populations across the care continuum, with a focus on providing coordinated and integrated care to prevent unnecessary admissions or readmissions.
- Provide discharge planning coordination and intervention for high-risk patients presenting to the Emergency Department.
- Strive to promote patient wellness, improved care outcomes, efficient utilization of health services, and minimized denials of payment among a patient population with complex health needs.
- Graduate of an accredited school of nursing.
- RN-Registered Nurse of California.
- BLS-Basic Life Support Healthcare Provider.
- CCM - Certified Case Manager (certification may be required by entity and time to acquire may be dependent on qualifications for exam).
- 2 years recent relevant experience.
- A broad knowledge base of health care delivery and case management within a managed care environment.
- Comprehensive knowledge of Utilization Review, levels of care, and observation status.
- Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system.
- A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements.
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. We offer a comprehensive benefits package, including competitive pay, health insurance, retirement savings, and paid time off. Our team is dedicated to providing exceptional patient care and promoting a positive work environment.
