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Patient Care Coordinator

2 months ago


San Francisco, California, United States Sutter Health Full time
Organization:

Sutter Health

Position Overview:

The Registered Nurse (RN) Case Manager plays a pivotal role in Care Coordination, Care Transitions, Discharge Planning, and Utilization Management throughout the acute care patient journey.

This position requires collaboration with physicians, medical social workers, and bedside nurses to ensure the efficient transition of patients to the appropriate level of care, thereby preventing unnecessary admissions or readmissions.

The RN Case Manager oversees the management of acute patient populations across the care continuum, focusing on delivering coordinated, timely, and integrated care.

The RN Case Manager reports to the Supervisor, Manager, or Director of Care Coordination within the facility.

Frequent interactions with patients, families, physicians, interdisciplinary teams, nursing management, quality assurance, ancillary services, third-party payers, review agencies, claims and finance departments, medical directors, contracted providers, and community resources are essential.

Job Responsibilities:

EDUCATION:
Equivalent experience may be accepted in lieu of the required degree or diploma.

Bachelor's Degree:
BS in Nursing or Health Administration.

Master's Degree:
Master's in Nursing, Case Management, or a related field.

CERTIFICATION & LICENSURE:
RN - Registered Nurse of California (required)
CCM - Certified Case Manager (preferred)

PREFERRED EXPERIENCE:
Minimum of three (3) years in acute medical/surgical/ED/critical care nursing is required. A Master's in Nursing with a focus on Case Management may be considered in lieu of the three years of experience at the director's discretion.
Previous experience in Case Management is preferred.
Experience with electronic criteria and clinical assessments for patients with complex medical, emotional, and social needs is strongly preferred.

SKILLS AND KNOWLEDGE:
Excellent interpersonal communication and negotiation skills are essential.
A comprehensive understanding of healthcare delivery and case management within a managed care environment is required.
Knowledge of Utilization Review, levels of care, and observation status is crucial.
Some familiarity with healthcare reimbursement systems (HMO, PPO, PPS, CMS) is preferred.
Understanding of post-acute levels of care such as Home Health, Hospice, and Palliative Care is beneficial.
General knowledge of coding and DRG assignment processes is preferred.

Must effectively communicate and foster cooperation among patients, families, physicians, nurses, and other ancillary partners.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families is necessary.
Demonstrates a commitment to service excellence in all interactions and job responsibilities.
Functions to promote quality patient care and ensure a positive patient experience.
Strong verbal and written communication skills are required.
Excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities are essential.
Intermediate computer skills are necessary.
Ability to promote teamwork and effectively function in teams is crucial.

Job Shift:
Days

Schedule:
Per Diem/Casual

Position Status:
Non-Exempt

Employee Status:
Per Diem/Casual

Number of Openings:
1

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.