Registered Nurse Case Management Specialist

2 weeks ago

Mission Viejo, California, United States Mission Regional Medical Center Full time
Position: Registered Nurse Case Management Specialist

Overview


Become a vital part of a distinguished team of healthcare professionals dedicated to our fundamental principles of excellence, empathy, and community service. Mission Regional Medical Center, a proud member of Prime Healthcare, provides exceptional opportunities to broaden your professional journey while contributing to a community focused on impactful healthcare delivery.


As a 297-bed, non-profit medical facility, we offer a comprehensive range of inpatient and outpatient services to the residents of the Rio Grande Valley.

Recognized nationally for our outstanding clinical performance in various services, including maternity and orthopedic care, Mission Regional Medical Center has been committed to delivering high-quality healthcare for over six decades.


Equal Opportunity Employment


We are an Equal Opportunity Employer and do not discriminate against applicants based on veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you require special accommodations during the application process, please reach out to Human Resources.


Responsibilities


The Registered Nurse Case Management Specialist is accountable for overseeing the quality and resource management of all patients admitted to our facility from the moment of admission and throughout their healthcare journey.

This role involves acting as an advocate for patients, emphasizing cost-effectiveness, and demonstrating leadership to unify healthcare providers for a seamless care experience.

The approach is designed to ensure the attainment of quality, clinical, and cost-efficient outcomes while conducting a thorough and holistic review of medical records for medical necessity, service intensity, and illness severity.


Qualifications


Education and Work Experience:

  • Minimum of 5 years of professional experience post-graduation from an accredited nursing program and a valid state Registered Nurse license.
  • For candidates grandfathered prior to the specified date, a minimum of 5 years post-graduation from an accredited School of Social Work for Licensed Clinical Social Worker is acceptable, although RN Case Manager is preferred.
  • Five years of acute care nursing experience is preferred.
  • At least one year of experience in case management, discharge planning, or nursing management is preferred.
  • Current Basic Life Support (BCLS) certification upon hire and maintenance of certification is required.
  • Familiarity with Milliman and InterQual Criteria is preferred.
  • Proficiency in basic to intermediate computer skills is necessary.
  • Completion of Behavioral Violence Prevention Training within three months of hire and maintenance of certification is required.

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