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Job Description:
The role of the emergency department case manager is one of patient advocate of appropriate utilization of resources. The emergency department case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the patient’s health care needs through hospitalization and transition back to the community and does this in coordination with the interdisciplinary health team. The RN Case Manager is expected to function within the full scope of the nursing practice with specialized focus on care coordination, compliance, transition management, education, and utilization management.Education:
Bachelor of Science Accredited School of Nursing - Required
Experience:
1 year Nursing - Emergency or
1 year Care Coordination- Case Management/Social Services or
Equivalent Work Experience Required
Certifications/Licensures:
RN Registered Nursing - California Board of Nursing Required
BLS Basic Life Support - American Heart Association Required
ACM Accredited Case Manager - ACMA American Case Management Association or
CCM Certified Case Manager - CCMC Commission for Case Manager Certification Strongly Preferred
Skills:
Working knowledge of common diagnoses and procedures and the impact this will have to patients/families and their ability to manage their care outside of the hospital. Specialized knowledge may be required for certain areas of practice.
Knowledge of individual and family development over the life span.
Knowledge of cultural and spiritual values and the impact they have on health care decisions.
Strong knowledge of Medicare and Medi-Cal guidelines and benefit resources as applicable to hospitalization and transition planning.
General knowledge of commercial coverage plans and usually covered benefits. Strong understanding of various reimbursement models and impact to care delivery, patient management and reimbursements such as ACOs, DRGs, Full Risk, etc.
Strong understanding of the criteria, rules and regulations around Inpatient, Observation and Outpatient levels of patient management. Strong knowledge of geriatrics and the impact to health and function in the aged as well as a working knowledge of chronic/progressive disease states such as CHF, COPD, Diabetes and End Stage Renal Disease, etc. Clear understanding of the role of the inpatient Social Worker and Palliative Care Resources.
Strong written and verbal communications skills.
Ability to plan, organize, manage time and prioritize work in collaboration with others.
Ability to work independently and as a part of a multidisciplinary team.
Effective problem solving and conflict resolution skills.
Ability to work respectfully and creatively with patients with diverse functional abilities, social, economic and cultural backgrounds to support clinical needs and safe transitions from the hospital.
Leadership skills to delegate and provide direction/guidance to staff and hold others accountable.
Able to learn and work in a variety of computer programs, including EPIC, Allscripts/CarePort, InterQual and Microsoft Outlook.
Work Shift:
12.0 - 09:00 - 22:00 No Waive (United States of America)Pay Range:
$80.54 - $109.74HourlyNote: Positions at JMH which are exempt (not eligible for overtime) under the level of Manager are listed as hourly for compensation purposes on this posting. The work shift will contain the word ‘exempt’ on it.
Scheduled Weekly Hours:
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