RN Case Manager
Apply NowCompany: Care Navigators On Demand
Location: Fullerton, CA 92833
Description:
Job Description
Qualifications for RN Case Manager:
Requirements for Case Manager:
Qualifications for RN Case Manager:
- The Case Manager is responsible for managing a continuum of care from admission through discharge for assigned patients.
- Partners with medical staff, utilizes scientific evidence for best practices, relevant data and compliance with the mission/philosophy, standards, goals and core values.
- Participates in the development of patient focused long/short term goals, implementing, evaluating and modifying the care plan.
- Collects and reports utilization data and quality information, such as delays in service, possible avoidable days, provider preventable conditions, readmissions, and length of stays, etc.
- Assists in preparing UM/QI case issues, gathering requested records/responses.
- Consults with the nursing staff working directly with clients in the nursing care areas.
- Maintains current knowledge of evidence based nursing care practices.
- Educates nursing staff about state and federal rules and regulations in preparation for accreditation.
- Evaluates and verifies employee performance through the review of completed work assignments and work techniques.
- Ensures delivery of quality care to patients, enhancement of business development, and continuous improvement of agency efficiency and fiscal success.
- Provides instruction to hospitalized members and their families; and serves as liaison between the member, the physician, the hospital and the Plan.
- Case Manager completes appropriate, accurate and timely, documentation into EMR system every shift
Requirements for Case Manager:
- Active CA Registered Nurse
- Acute clinical experience
- Experienced in case management, UR/UM
- Possesses knowledge of applicable regulatory standards and is able to perform audits based upon these standards
- Solid experience dealing with UR concepts
- Computer literate