RN Case Manager

Community Memorial Health System
vision insurance, paid time off, tuition reimbursement, 403(b), retirement plan
United States, California, Ventura
Nov 15, 2024
Compensation Salary Range: $51.10 - $79.61 / hour The pay range above represents the lowest possible rate for the position and the highest possible rate. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. If you are viewing this posting on a job site, please visit our company page and search for the opportunity to view the pay range: https://careers-mycmh.icims.com/jobs Pay for PRN positions is calculated differently than Full-Time, Regular Part-Time, and Part-Time positions. PRN Rates depend on the position and other factors, including years of experience, or shift commitment according to the department policy. PRN differential is added in certain positions. Responsibilities Position Overview: The RN Case Manager (RN CM) II works with patients and families with the healthcare team in the collaborative development of a plan for discharge and arrangement of any needed post-acute care services. Additionally, the RN CM II assists with gathering data to ensure that patient care provided meets approved admission criteria, continued stay and appropriate level of care. Qualifications Required: Associate Degree in Nursing (ADN) or higher Current CA Registered Nurse (RN) License Current Basic Life Support (BLS) Certification One (1) year of case management experience One (1) year of acute care experience Preferred: Bachelors of Science in Nursing (BSN) Bilingual in Spanish Experience in Case Management and strong discharge planning skills Previous experience with InterQual Previous experience with Allscripts and Meditech Essential Functions and Responsibilities: Acts as liaison between physicians, nursing, other hospital departments, community agencies, health plans, patients and families. Conducts discharge and transitional care planning. Involves and educates patients and families regarding discharge planning and community resources. Collaborates with appropriate community resources on behalf of patients. Refers to Social Services when appropriate. Refers quality of care issues according to policies and procedures. Reports suspected or actual abuse. Participates in Process Improvement activities. Works independently and exercises sound judgment in interactions with physicians, payers, patients and families. Demonstrates strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components. Applies approved clinical criteria to monitor admissions and continued stays and documents findings based on Department standards. Pursues authorizations for acute stays and potential needs from third party payers. Monitors LOS and ancillary resources on an ongoing basis. Takes actions to report Discusses w/physicians potential delays and/or LOS. Understands and acts in compliance with Medicare regulations. Facilitates patient's right to appeal. Assesses for and facilitates transitions of care. Maintains communication with post-acute providers. Utilizes critical thinking skills and judgment to evaluate the clinical and psychosocial condition of all patients. Involves and educates patients and families regarding discharge planning and community resources. Effectively manages and teams cases with social work, palliative care team and intensive case management. Ensures that patient evaluations are complete and reflect a comprehensive evaluation of the patient. Assures that Discharge plan is in place in a timely fashion. Acts as a liaison between physicians, nursing, other hospital departments, community agencies, health plans and patients/families. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency. Supports department based goals. Serves as a preceptor, mentor and resource to less experienced staff Performs other duties as assigned Overview When it comes to quality, we're 5 Star! Community Memorial Health System was established in 2005 when Community Memorial Hospital in Ventura merged with Ojai Valley Community Hospital. It is comprised of these two hospitals along with a network of primary and specialty care health centers serving various communities across west Ventura County. Our health system is a community-owned, not-for-profit organization. As such, we are not backed by a corporate or government entity, nor do we answer to shareholders. We depend on - and answer to - the communities we serve. Community Memorial Hospital - Ventura has been awarded a prestigious five-star rating by the Centers for Medicare & Medicaid Services (CMS)! This achievement represents thousands of people going the extra mile every day for our patients, and we are the ONLY hospital in Ventura County to earn this distinction! Community Memorial Healthcare Benefits To help heal, comfort, and promote health for the communities we serve, Community Memorial Healthcare takes care of our community of employees so our local community can be cared for. That's why we provide competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family's health and wellness in all aspects of life. From our top tier insurance plans to our employee assistance program, take advantage of what CMH has to offer so you and your loved ones can have peace of mind now and for years to come. CMH is here for you and your family every step of the way. Competitive Pay Shift Differentials In-House Registry Rates Fidelity 403(b) Retirement Plan Paid Time Off Medical (EPO/PPO), Dental, & Vision Insurance Coverage Voluntary Worksite Benefits Employee Assistance Program Available 24/7 (EAP) Tuition Reimbursement Public Service Loan Forgiveness (PSLF) Recognition programs Employee service recognition events Home, Retail, Travel & Entertainment Discounts National Hospital Week and National Nurses Week celebrations Community Memorial Healthcare is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. We strive to promote an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work in our community. "We are an AA/EEO/Veterans/Disabled Employer"