Address
Form of work
SalaryRN, Case Manager
- (MEM007855)
Title RN, Case Manager
Location Predominately remote
Department Inpatient Specialty Services
Status Per-diem
Shift Variable
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.
Purpose Statement / Position Summary
Under minimal supervision and in a professional and friendly manner, perform assigned job duties to the highest level of customer service and assistance to both internal and external customers.
Essential Functions and Responsibilities of the Job
1. Answer incoming calls from ED for authorization to admit or transfer per established workflow.
2. Support Inpatient Case Managers with chart review as delegated.
3. Initiate, evaluate and supervise patient discharge plan.
4. Adhere to turnaround times, goal length of stay and established bed day goals.
5. Evaluate risk for readmit.
6. Make follow up appointments when requested.
Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.
Experience
- Minimum 10 years’ experience as a Registered Nurse with demonstrated competence in all aspects of nursing care and independent decision making.
- Minimum two years’ experience in telephone triage.
- Minimum three years’ experience care management or similar area.
- Three years work experience in Microsoft Word, Microsoft Excel and Microsoft Outlook.
- Three years work experience applying evidence-based criteria (i.e.: Milliman, Interqual); Health plan medical policy / clinical coverage guidelines.
- Three years work experience with CMS (Centers for Medicare and Medicaid Services) coverage policies required.
Education
- Current California Registered Nurse (RN) license required
- Minimum of an Associate’s degree (AA) or equivalent from a two-year college or technical school. Prefer a Bachelor of Science in Healthcare or Nursing.
