- Bachelor's in Nursing strongly preferred.
- RN-Registered Nurse of California
- ACM-Accredited Case Manager preferred
- OR CCM-Certified Case Manager preferred
- Previous Leadership experience.
- Minimum 3 years previous acute care experience or equivalent education commensurate with is required.
- Previous case management experience. Broad acute clinical background (experience in more than one population and level of care) strongly preferred.
- InterQual experience.
- Knowledge: Utilize critical thinking skills and clinical knowledge to create a viable and effective patient transition plan and identify delays in service, or quality issues that impede the progression of care required.
- Basic knowledge of governmental (Medicare, Medi-Cal, etc.) healthcare reimbursement systems is preferred.
- Advanced knowledge of healthcare reimbursement systems: HMO, PPO, capitated agreements, PPS, etc., preferred.
- Advanced knowledge of post-acute healthcare resources such as: SNF, Home Health, Hospice, AIM, etc., required.
- Intermediate level computer skills required. General typing skills (35 WPM) required.
- General knowledge of coding and DRG assignment process preferred.
- Must be able to effectively communicate with, and promote cooperation and collaboration between, multiple people including: patients and their families; physicians, nurses, social workers, etc.
- Ability to seek input and receive feedback in a collaborative interdisciplinary team.
- Able to orchestrate successful, complex discharge plans.
- Must be able to develop an organized work plan in a high-volume environment with rapidly changing priorities.
- Must possess leadership, delegation, and supervisory skills to guide staff and hold others accountable.
- Must be self directed and organized with the ability to independently prioritize and follow through to achieve desired clinical, satisfaction and financial outcomes.
- Must have strong clinical assessment skills necessary to provide utilization review and transition planning services to meet the patients' complex medical, emotional and social needs.
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case manager, registered nurse - Jackson, CA , USA, United States - Sutter Health
Description
Organization:
SAH-Sutter Amador Hospital
Position Overview:
The Case Manager assists the organization by assuring that the right care is provided at the right place, at the right time.
To accomplish these goals, the Case Manager:
uses established criteria to evaluate the appropriateness of admission, level of care, and readiness for discharge; assures the timely movement of patients throughout the continuum of care by conducting concurrent reviews and resolving delays as necessary; assesses patients' post-discharge needs and develops and implements the plan; submits clinical information to assure reimbursement; and coordinates care with the treatment team, family and others as necessary.
Job Description:
EDUCATION
PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:
SKILLS AND KNOWLEDGE
Job Shift:
Days
Schedule:
Full Time
Shift Hours:
8
Days of the Week:
Variable
Weekend Requirements:
Every other Weekend
Benefits:
Yes
Unions:
Yes
Position Status:
Non-Exempt
Weekly Hours:
32
Employee Status:
Regular
Number of Openings:
1
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $65.70 to $87.46 / hour
The salary range for this role may vary above or below the posted range as determined by location.
This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled.
Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs.
Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.
