Case Manager, RN

Pay Range: CASE MANAGER, RN - $51.31 to $78.76 Job Summary The RN Case Manager-Pre Access is responsible for screening, coordinating, and facilitating admission review of all acute patients. Working collaboratively with all interdisciplinary staff, facilitates admission and transfer of patients, ensure that each patient is admitted meeting established medical guidelines in collaboration with credentialed medical staff, assist with the coordination of patient transfers into the hospital, and communicates all requested and questionable admissions/transfers to the Director of Case Management , and/or Physician Advisor. Licensure and Certification Current CA RN license Current BLS provider card Case Management certification preferred Education Diploma, AA, BS in Nursing MS in Nursing preferred Experience Two (2) years as a Case Manager in an acute care setting or five years recent acute care nursing experience preferred. Experience in Critical Care setting preferred Demonstrates strong interpersonal skills, leadership ability, negotiation skills, and knowledge of hospital operations. General knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential. Advanced experience utilizing InterQual required. Knowledge and Skills Develops, maintains, and models professional, objective and value-oriented interpersonal skills. Continuously promotes a patient-centered philosophy. Maintains positive and proactive communication with patients, families, staff members, and physicians. Fosters team-building relationships Excellent organizational skills and the ability to problem solve are essential Strong interpersonal skills, leadership, negotiation skills, good leadership talent Knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential Knowledge of State and Federal regulations; e.g. EMTALA, Medi-Cal, HMOs, etc. Understanding of Medicare, Medi-Cal and other Third Party Payer regulations Understanding of current utilization/quality management principles, techniques and procedures #J-18808-Ljbffr International Executive Service Corps