Sutter Health RN Case Manager (Crescent City, CA) (Per Diem) in Crescent City, California
This position is responsible for the following case management functions: discharge planning, DRG assurance, insurance audits, Inter Qual criteria assessment for admission and continued care, utilization review and quality measures. As the Case Manager, this position is responsible for the assessment of case management needs for inpatients, management of patient throughput, and the development of discharge plans. Responsible for the concurrent review of the medical record for both discharge planning and insurance review. This position facilitates interdisciplinary team conferences and assists with medical staff patient care conferences.
High School Diploma Required
Associates Degree and/or Bachelors of Nursing Degree Required
CA RN License Required
Basic Life Support through American Heart Association Required
Prior experience in healthcare in the areas of case management and utilization review with good to excellent word processing and computer skills preferred. Minimum of two years experience in the acute care setting. Certification in the area of case management preferred.
Experience/Knowledge and Skills:
Demonstrated knowledge of corporate organizations and healthcare organizations is highly desirable. Knowledge of Title 22, TJC, CMS & HIPPA standards and regulations as they relate to discharge planning and utilization review is also highly desirable. Knowledge of performance improvement methodology, utilization criteria (IS/SI), department policies and procedures and principles of discharge planning is essential. Significant knowledge of personal computers and related software is essential. Knowledge of Microsoft Windows, Excel, and PowerPoint is preferred.
Must be able to communicate effectively both orally and in writing with hospital management, medical staff, patients, team members and the public. Must demonstrate effective organizational and problem solving skills and the ability to balance multiple priorities at any given time. Must be detail oriented, self-directed and be able to work with little or no supervision, and maintain a high confidentiality of information. Must be able to use a computer, have advanced word processing skills and data base work. Must demonstrate exceptional customer service skills using tact and diplomacy when necessary. Must demonstrate effective teaching skills.
Primary Location: California, North Coast, Crescent City
Organization: Sutter Coast Hospital, Crescent City, CA
Employee Status: Regular
Employee Referral Bonus: No
Position Status: Non-Exempt
Job Shift: Day/Evening
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Varied Days
Weekend Requirements: Rotating
Schedule: Per Diem
Hrs Per 2wk Pay Period: .01
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.