Case Manager RN

Job Description:

The Care Coordinator has responsibility for coordinating the care and services for assigned patients for an episode of illness or treatment in collaboration with the patient, family, physician, patient care team, and payors. The Care Coordinator utilizes advanced clinical skills to facilitate the provision of care which includes the assessment, planning, intervention and evaluation principles of the nursing process. The Care Coordinator promotes and evaluates the effective utilization of resources using current clinical knowledge, awareness of community services, and assuming a leadership role with the patient care team to achieve optimal clinical and resource outcomes. The Care Coordinator evaluates and analyzes quality/utilization cases, admission/discharge criteria, observation/1-day stays, readmits in 30 days, Medicare and diagnosis related criteria. Participates in outlier review on an ongoing basis. In addition, the Care Coordinator may be assigned to the Emergency Department. In collaboration with the patient/family, multidisciplinary team including physicians and payors ensure the patient’s progress along with emergency episode of care in an efficient and cost effective manner for assigned case load. Advocates for the patient and family throughout the entire episode of care. Maintains availability to the patient/family as a resource to facilitate communication among providers and to monitor services rendered. Remains involved until the patient is discharged or appropriately transferred to the acute care setting or an alternate level of care. Initiate appropriate clinical pathways based on admission diagnosis and to serve as a resource person for utilization management purposes.

Minimum Requirements:
- At least one year of recent Case Management experience in an acute care setting
- Current CA Licensure
- Current CPR recognition