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RN Case Manager Full Time Days - Indio, CA, United States - John F. Kennedy Memorial Hospital
Description
JFK Memorial Hospital has provided medical care to residents in the Coachella Valley since 1966. A group of physicians, including Dr. Reynaldo Carreon, founded the hospital and today one of JFK's cross streets is named in his honor.
Originally called Indio Community Hospital, JFK has grown to a 145-bed acute-care hospital that is part of Tenet Healthcare California. It offers a variety of services, including:
•Emergency care 24/7
•Orthopedic and joint replacement services using emerging technology
•Cardiovascular services
•Maternity care and pediatric services
•Ambulatory surgery center
•Imaging services
•Outpatient Rehabilitation Center
POSITION DESCRIPTION:
The scope of duties encompasses a variety of tasks related to performing the following: integrated concurrent review for utilization; quality and risk; discharge planning; and case referrals for patients. This position works with medical and professional staffs to obtain appropriate clinical documentation for review and to meet inpatient criteria by the Interqual Guidelines. The Case Managers are responsible for the research and appeal UR denials; micro management of patients to ensure appropriate and timely resource utilization; timely and accurate communication to insurance utilization review for certification of admission and continued stay. This position also coordinates patient care with an interdisciplinary team; screens and coordinates authorization of requests for capitated services for all assigned managed care where the hospital has a financial responsibility; participates in peer review; and is pro-active in reducing avoidable days. Hours vary depending upon assignment. Rotate Saturday/Sunday coverage. This is a non-exempt position.
QUALIFICATIONS:
1. Current license as a Registered Nurse in California, or related health care professional
2. 1-3 years Case Management/UM experience in an acute care facility
3. CPR
4. Knowledge and experience with Medi-Cal - preferred
5. Good communication skills and ability to work with others
6. Basic computer skills
MANDATORY REQUIREMENTS:
1. Requirements:
Annual Requirements:
§ Orientation
§ Annual Update
§ Ethics Training
§ Child Abuse Identification
§ Elder Abuse Identification
§ Conflict Resolution
§ California RN License
§ CPR
Pay Range: $50.88 Minimum - $81.65 Maximum an hour
Individual wages are determined based upon a number of factors including, but not limited to, an individual's qualifications and experience
Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.
Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.