Case Manager ECH: Case Management

4 weeks ago

Loma Linda, California, United States Loma Linda University Medical Center Full time
Job Summary:

The Case Manager plays a vital role in the patient care delivery team at Loma Linda University Medical Center, a Magnet Recognized academic medical center with level one trauma designation and Comprehensive Stroke Center accreditation.

As a key member of the team, the Case Manager utilizes clinical expertise, discretion, and independent judgment to perform the nursing process, ensuring patient-centered care and adherence to case management functions.

Maintaining a solid working knowledge of specialized case and utilization management methodologies, the Case Manager applies concepts to everyday practice, ensuring medical appropriateness criteria are met for the level of care provided.

Collaborating with the healthcare team, the Case Manager oversees the implementation of a well-thought-out interdisciplinary plan of care, with an individualized discharge plan that meets the continuing healthcare needs of the patient.

Reevaluating the plan of care, the Case Manager ensures continued appropriateness based on the patient's changing needs and condition.

Exhibiting positivity and serving as an instrumental change agent, the Case Manager minimizes resistance to change in the workforce, clinical practice, and operational setting.

Engaging in opportunities to influence decision-making for bedside clinical practice, the Case Manager participates in professional governance councils, committees, taskforces, and staff meetings.

Performing other duties as needed, the Case Manager demonstrates ability to be an effective change-agent for implementation of new processes to achieve desired outcomes/performance measures.

Requirements:
  • Bachelor's Degree in nursing required
  • Minimum of one year of patient care experience required
  • Minimum of two years of Hospital Case Management or Utilization Management experience preferred
Knowledge and Skills:
  • Basic knowledge of case and utilization management practice and methodologies and state and federal healthcare regulations and accreditation required
Essential Functions:
  • Speak, read, and write legibly in English (and Spanish preferred) with professional quality
  • Use computer, printer, and software programs necessary to the position
  • Relate and communicate positively, effectively, and exhibit professional behavior at all times
  • Work calmly and respond courteously when under pressure
  • Be assertive and consistent in following policies
  • Teach, collaborate, accept direction, think critically, work independently, perform basic math and statistical functions, manage multiple assignments effectively, organize and prioritize workload, problem solve, recall information with accuracy, pay close attention to detail, hear sufficiently for general conversation, identify and distinguish various sounds associated with the workplace, see adequately to read computer screens, medical records, and written documents necessary to the position
Licensures and Certifications:
  • Active California Registered Nurse (RN) license required
  • Basic Life Support (BLS) certification issued by the American Heart Association required
  • Nationally recognized certification in Utilization Management or Case Management preferred

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