CASE MANAGER- FT

Job Details Location: Hospital - Loma Linda, CA 92354 Position Type: Full-Time/Part-Time Education Level: Not Specified Salary Range: $48.00 - $52.92 hourly Travel Percentage: Road Warrior Job Shift: Day Job Category: Health Care Job Summary The Case Manager/Case Finder utilizes clinical expertise, discretion, and independent judgment to assess, provide, coordinate, and monitor healthcare services for assigned patients. The role ensures medical necessity criteria are met for care at acute and sub‑acute units, documents services from admission through discharge—including readmissions—and participates in patient discharge teaching when appropriate. Acting as a liaison among the patient, family, interdisciplinary team, community, hospital staff, insurance companies, and other providers, the Case Manager communicates authorizations, coordinates care plans, and collaborates with the billing department. The position also supports marketing activities representing the hospital, supports Core Values, aligns with the strategic plan, and participates in quality assurance and performance improvement activities. Key Responsibilities Assess and coordinate healthcare services for patients to meet medical necessity criteria. Document care from admission to discharge, including readmissions. Participate in patient discharge teaching and coordinate post‑discharge care. Serve as liaison between patient, family, interdisciplinary team, community, hospital staff, insurers, physicians, and other providers. Communicate with billing to obtain authorizations for admissions, services, and outpatient care. Collaborate with marketing on vendor marketing activities. Support Core Values, organizational strategic plan, and quality assurance processes. Qualifications Current California Registered Nurse (RN) licensure. Bachelor of Science in Nursing or related field required; Master’s preferred. Current Basic Cardiac Life Support (BCLS) certification. Minimum 2 years acute or sub‑acute nursing experience; pediatric care experience preferred. Certification in Case Management preferred or ability to obtain it. Knowledge of case management theory/practice and current psychosocial issues. Strong work ethic, professional image, and ability to manage confidential information. Knowledge of CMS conditions of participation, CDPH regulations, CCS, and TJC requirements. Working knowledge of computer and software applications. Excellent communication, interpersonal, collaboration, and conflict‑resolution skills. Capability to work independently and in a team environment. Knowledge of Health Care Environment Practice Knowledge Knowledge of current practice and roles of patient care team members. Compliance with state and federal regulatory standards and organizational policies. Adherence to professional association standards of practice. Patient Safety / Risk Management Support development of organization‑wide patient safety program. Maintain patient confidentiality at all times. Performance Improvement / Outcome Measurement Knowledge of the organization’s QAPI program. Communication and Relationship Management Effective Communication Demonstrate effective interpersonal communication skills. Provide clear and effective written and verbal communication. Use positive verbal and non‑verbal communication. Relationship Management Build collaborative relationships within the organization. Exhibit effective conflict resolution skills. Professionalism Personally and Professionally Accountable Hold self and others accountable for professional expectations and outcomes. Adhere to dress code policy. Treat customers with respect, courtesy, and confidentiality. Show willingness to assist. Comply with code of conduct and compliance standards. Use timekeeping system accurately. Career Planner Maintain professional license and/or certification. Act on feedback regarding strengths and weaknesses. Complete annual educational and health requirements. Trustworthy Show prudence in caring for staff and the organization. Be consistently reliable, truthful, and honest. Convey important information accurately. Maintain competency to achieve reliable positive outcomes. Benefits Competitive wages and benefits. Night and weekend differentials. $500 sign‑on bonus. Team‑centered philosophy of care. About Totally Kids Rehabilitation Hospital Distinctive campus devoted 100% to children. National leader in rehabilitation and habilitation programs with a family‑centered emphasis. Consistently awarded the Gold Seal of Approval by the Joint Commission. Trusted destination for physicians and parents for more than 50 years. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or other protected status. #J-18808-Ljbffr Totally Kids Rehabilitation Hospital