RN, Case Manager
6 days ago
As a skilled RN, Case Manager, you will play a vital role in optimizing patient health status and goals at MemorialCare Health System. This dynamic position requires a professional and friendly demeanor, with a focus on delivering exceptional customer service and assistance to internal and external customers of the Case Management unit.
Key Responsibilities
• Identify and evaluate members for enrollment into MemorialCare's Case Management programs through physician referral, utilization data, and other sources.
• Assess, plan, implement, coordinate, monitor, and evaluate all options and services to optimize patient health status and goals.
• Adhere to CM Standards of Practice and use evidence-based clinical treatment guidelines, preventive guidelines, protocols, and other metrics in the development of Care Plans and Shared Action Plans.
• Monitor outcomes of the plan, ensuring adherence to regulatory requirements and patient-centered care, promoting efficiency and quality in the delivery of healthcare.
Requirements
• Previous Case Management experience preferred.
• Work experience in Microsoft Word, Microsoft Excel, and Microsoft Outlook required.
• Work experience applying evidence-based criteria, health plan medical policy, and clinical coverage guidelines required.
• A minimum of two (2) years' Clinical Nursing Experience in a hospital or like setting required.
• Knowledge of CMS coverage policies required.
• Current California Registered Nurse license (RN) required.
• Associate's degree (AA) in nursing or equivalent from a two-year college or technical school required.
• Bachelor of Science in Nursing, or related field preferred.
• CCM preferred.
About MemorialCare Health System
MemorialCare Health System is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare, and your personal contributions are integral to our recognition as a market leader and innovator in value-based and other care models.
Why Join Our Team?
At MemorialCare Health System, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. We offer high-quality health insurance plan options, so you can select the best choice for your family, and there's more... Check out our MemorialCare Benefits for more information about our Benefits and Rewards.
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