Case Manager II - Oceanside, California, United States

Job Locations · US-CA-Oceanside · Overview · -City Medical Center has served San Diego County's coastal communities of Carlsbad, Oceanside and Vista, as well as the surrounding region for more than 60 years and is one of the largest employers in North San Diego County. Tri-City i ...

Job description

Job Locations

US-CA-Oceanside

Overview

-City Medical Center has served San Diego County's coastal communities of Carlsbad, Oceanside and Vista, as well as the surrounding region for more than 60 years and is one of the largest employers in North San Diego County. Tri-City is administered by the Tri-City Healthcare District, a California Hospital District. As a full-service acute care public hospital with over 500 physicians practicing in over 60 specialties, Tri-City is vital to the well-being of our community and serves as a healthcare safety net for many of our citizens. The hospital has received a Gold Seal of Approval from the Joint Commission showcasing a commitment to safe and effective patient care for the residents of the community. 

Tri-City Medical Center prides itself on being the home to leading orthopedic, spine and cardiovascular health services while also specializing in world-class robotic surgery, cancer and emergency care. Tri-City's Emergency Department is there for your loved ones in their time of need and is highly regarded for our heart attack and stroke treatment programs. When minutes matter Tri-City is your source for quality compassionate care close to home. Tri-City partners with over 90 local non-profit and community organizations as part of our COASTAL Commitment initiative. Together we are helping tackle some of our communities' pressing health and social needs.

Position Summary:

The Case Manager II assumes responsibility for the coordination of services in order to maximize patient outcomes. Inherent in the position is assessment, evaluation, collaboration and coordination of patient care delivery systems and participation in appointed service line activities.  Emphasis is on cost-effective and cost-efficient strategies which maximize quality care within the current health care environment for the identified patient population.  The Case Manager II is responsible for the coordination of utilization management, discharge planning and other health care services/systems. The Case Manager II functions as a contact person, coordinator and facilitator for the patient, family, health care team members and claims/insurance personnel as necessary.

Major Position Responsibilities:

The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.

• Patient Care:
  • Conduct comprehensive assessments to identify patient needs and develop individualized discharge care plans.
  • Responsible for the coordination of services in order to maximize patient outcomes.
  • Assess, evaluate, collaborate and coordinate patient care delivery systems and participation in appointed service line activities.
  • Responsible for the coordination of utilization management, discharge planning and other health care services/systems.
  • Functions as a contact person and facilitator for the patient, family, health care team members and claims/insurance personnel as necessary.
  • Act as a patient advocate, ensuring dignity and confidentiality. 
  • Demonstrate empathy and compassion for patient experience.
  • Advocate for evidence-based practices in case management and utilization review.
• Safety and Compliance:
  • Maintain a safe, clean working environment, adhering to infection control and hospital policies.
  • Comply with regulatory standards (e.g., The Joint Commission, OSHA).
  • Identify and report safety concerns proactively. 
  • Ensures cost-effective and cost-efficient strategies which maximize quality care within the current health care environment for the identified patient populations.
• Documentation:
  • Accurately document assessments and patient interactions in the Electronic Health Record (EHR) according to Department Standards
• Professional Development and Leadership:
  • Provide preceptorship and mentorship to New Graduate Nurses, New Hires, and students, supporting their professional development.
  • Participate in continuing education and quality improvement initiatives. 
  • Serve as a resource for best practices within Case Management.
• Emergency Preparedness:
  • Activate emergency response system during patient emergencies (e.g., Rapid Response Team (RRT) situations).

Qualifications:

• Two (2) years of experience as a Registered Nurse in case management or utilization management, required
• Knowledge of Prospective Payment System and The Joint Commission standards and regulatory requirements pertaining to Utilization Management and Discharge Planning required.

Competencies:

• Technical Skills:
  • Proficient computer skills, including Word.
  • Knowledge and understanding of various payer types
  • Experience with referral management system, preferred
• Critical Thinking:
  • Rapid decision-making skills and ability to pivot plans on short notice
  • Ability to prioritize tasks
• Communication:
  • Effective verbal and written communication with the patients, families, and the multidisciplinary team.
  • Strong interpersonal skills to support a collaborative team environment.

Education:

• Bachelor of Science in Nursing (BSN) or may consider Associate Degree, Nursing (ADN) with 5 years' experience as a Registered Nurse in case management in lieu of BSN, required.

  Licenses:

• Current California Registered Nurse, required.

Certification:

• Accredited Case Manager (ACM) or Certified Case Manager (CCM), or equivalent certification, preferred.

Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.

*Salary/Hourly Wage range based on experience.

TCHD is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with a disability.