RN Case Manager, 13 weeks - Travel

RN Case Manager, Travel Contract, Days, Los Alamitos, CA - 13 Weeks

Workdays may vary which will include weekends and holidays. 8:00am - 4:30pm, 5X8s, 40 hours per week

Minimum five (5) years of clinical experience and one (1) year of previous Case Management experience.

Required Education: Bachelor of Science in Nursing.

Must have: Certifications & Licensure: Current RN CA License & BLS required.

Preferred Certification: CCM -ACM -Case Management credentialing

Duties: - Job Summary: Incumbent is responsible for a high level assessment and reassessment process for the patient/family to set priorities, plan, organize, and implement care that is goal-directed toward self-care outcomes. Collaborates with an interdisciplinary approach to care facilitation to promote and coordinate the delivery of high quality, individualized, safe and cost-effective patient care and transitions of care. Advocates for patient self-determination and choice. Practices cultural competence in evaluations and planning with awareness and respect for patient and family diversity. Monitors and coordinates resource utilization throughout the health system and evaluates services provided. Performs the appropriate utilization review functions utilizing medical staff-approved decision support criteria (InterQual Intensity of Service, Severity of Illness criteria). Concurrently intervenes to enhance patient quality outcomes where appropriate. Ensures clinical information in the medical record is clear and complete reflecting the patient's true severity of illness through interfacing with physicians to improve the overall quality of the clinical documentation.

Job Responsibilities: -Participates in the care of the patient and in caregiver meetings; respecting and promoting the patient's self-determination, informed and shared decision making, autonomy, growth and self-advocacy. -Develops long and short term goals consistent with treatment plans, standards of practice, and the patient's plan of care. -Completes appropriate and timely discharge planning assessments and reassessments and documents concurrently in the patient's medical record in compliance with hospital policy and State and Federal regulatory requirements (i.e. as CDPH, TJC, CMS). -Collaborates as needed with the patient and family to optimize client outcomes. -May include work with community, local and state resources, primary care provider, members of the health care team, payer, and other relevant health care stakeholders to facilitate appropriate patent transfers, discharges and transitions of care. -Identifies timely and effective alternative lower level of care settings for patient care in accordance with the patient's medical necessity, stability, the patients' preferences and health plan benefits. -Identifies timely post-hospital nursing care needs and arranges for services as appropriate. -Provides patient and family appropriate resources and/or referrals. -Makes timely and appropriate referrals to, and seeks consultation with others when needed, the patient-centered provision of services; such as Social Services (i.e., Durable Power of Attorney). -Applies Decision Support criteria (InterQual guidelines and/or other hospital approved utilization review criteria) to determine appropriate level of care and length of stay. -Ensures utilization review is completed and documented concurrently and provided to the patient's payer as required. -Acts as an effective liaison to medical staff to ensure continuity and congruity of hospital services in accordance with the patient's plan of care. -Responsible for the achievements and success of client. -Follows through and meets commitments; accountable for own actions and supportive of colleagues; presents self in appearance and actions in a manner that conveys professionalism and pride in area of responsibility; projects a positive presence and ensures that work related or personal frustrations are kept separate from patient care and professional activities; takes responsibility for problems and solutions; follows existing policies and procedures.

Skills: - Required Skills & Experience: -Minimum five (5) years of clinical experience and one (1) year of previous Case Management experience. -Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties. -Must possess complete understanding of acuity levels for specific patient population. -Must demonstrate customer service skills appropriate to the job. -Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. -Ability to facilitate and lead interdisciplinary rounds. -Ability to establish and maintain effective working relationships across the Health System. -Excellent written and verbal communication skills in English. -Computer literacy and proficiency. Preferred Skills & Experience: -Knowledge of University policies and procedures. -Knowledge of California Children's Services benefits authorization process (CCS). -Familiarity of Joint Commission, CMS, CDPH. -Bilingual skills.