Case Manager II- Sharp Memorial Hospital - FT - Days

About this role

Hours :

Shift Start Time: Variable Shift End Time: Variable

AWS Hours Requirement: 8/80 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements: As Needed

On-Call Required: No

Hourly Pay Range (Minimum - Midpoint - Maximum): $69.070 - $75.080 - $96.480   The stated pay scale reflects the range as defined by the collective bargaining agreement between Sharp HealthCare and Sharp Professional Nurses Network, United Nurses Associations of California/Union of Health Care Professionals, NUHHCE, AFSME, AFL-CIO.  Placement within the range is based on years of RN experience.

What You Will Do The RN CM II assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the appropriate setting and level of care. The position creates a balance between individual clinical needs with the efficient and cost-effective utilization of resources while promoting quality outcomes. This position requires critical thinking and advanced problem-solving and time management skills. The CM II will partner with ICM leadership to mentor and precept new hires (CMI, SW, LVN Care Coordinators and CRCs).

Required Qualifications • Bachelor's Degree in Nursing or equivalent degree. • 2 Years recent pertinent clinical experience as defined by the CBA.

• 3 Years acute care nursing experience or case management experience.

• 3 Years case management, utilization review, care coordination experience. • California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED

Preferred Qualifications • Master's Degree • Certified Case Manager (CCM) - Commission for Case Manager Certification -PREFERRED

• Accredited Case Manager (ACM) - American Case Management Association (ACMA) -PREFERRED

Essential Functions • Professional development The RN CM II will: Actively participates in the performance planning, competency and individual development planning process. Maintain current knowledge of case management, utilization management, and discharge planning, as specified by Sharp, federal, state, and private insurance guidelines. • Core principles The RN CM II will make timely referrals to ensure that the patient is receiving the appropriate care, in the appropriate setting and using the appropriate utilization standards as set by community and professional standard as adopted by the medical staff. The RN CM II will assure that the patients from all age groups proceed efficiently through the course of hospitalization and beyond through the continuum of care. The RN CM II will relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, collaborate and accept direction. The RN CM II performs other duties as needed. • Organizational relationships

The RN CM II will work closely with the healthcare team in reaching unit, facility, and system/network organization goals including reductions in length of stay, decreasing denials, improvement of care transitions, and reduction in avoidable readmissions, improved patient experience, and other quality initiatives. In the emergency departments, the RN CM II will work collaboratively with other members of the interdisciplinary team to develop relationships and provide preadmission status recommendations for admissions as well as implement a comprehensive, integrated discharge plan from the emergency department(ED) for patients who are being discharged to a lower level of care. The RN CM II will recommend and document patient classification (status and level of care) for all admissions utilizing established criterion sets. The RN CM II has accountability for maintaining compliance contractual and regulatory compliance with medical groups as applicable and the hospital. The RN CM II will have excellent interpersonal skills demonstrated by the ability to work effectively with individuals and or teams across disciplines. • Care coordination and discharge planning

Within 24 hours of admission the RN CM II will interview each patient/family for anticipated needs post hospitalization. The plan and interventions will be documented in the electronic medical record (EMR) and other supporting case management software. The RN CM II will ensure patient choice is obtained and documented in accordance with all state and federal regulatory requirements. The RN CM II will develop and document a plan for the day and plan for the stay with patient, family, providers, and nursing staff. The RN CM II will be responsible for leading the daily care coordination (multidisciplinary) rounds, update the plan, and facilitate necessary coordination of services. The RN CM II will document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion services. The RN CM II will prepare patient/family for discharge. Document expected discharge date per protocol and arrange discharge pick up appointment with family or significant other. In collaboration with SW partner, the RN CM II will follow standards for routine patient/family conference. The RN CM II will ensure effective and safe patient handovers to next level of care; work closely with ambulatory care manager (ACM) at the system level, in clinics, with SCMG and other complex care Case Managers as appropriate, and homecare and sub-acute liaisons. The RN CM II will support the nursing Model of Care by working closely with nursing managers and staff to achieve Patient and Family Centered Care goals: respect and dignity, information sharing, parti

Similar jobs

• Respiratory Care Practitioner – Sharp Memorial Hospital – Night Shift – Full Time — Sharp HealthCare · San Diego, CA
• Healthcare Assistant-7S Med/Surg-Sharp Memorial Hospital-Day Shift-Full-Time — Sharp HealthCare · San Diego, CA
• Account Analyst II - PFS Billing & Collections - Sharp Corporate - Day Shift - Full Time — Sharp HealthCare · San Diego, CA
• Cardiovascular Rad Tech II (Electrophysiology) – Cardiac Cath Lab - Sharp Memorial Hospital - Days - Full Time - 1.0 FTE — Sharp HealthCare · San Diego, CA
• Clinical Lab Scientist - Sharp Memorial - Day Shift - Part Time — Sharp HealthCare · San Diego, CA
• Medical Admin Assistant - SharpCare Float Pool - Full-Time - Day Shift — Sharp HealthCare · Chula Vista, CA