RN - Case Manager

Care Coordinator

The Care Coordinator is responsible for coordinating care and services for assigned patients throughout their episode of illness or treatment. This role involves collaboration with patients, families, physicians, the patient care team, and payors. Utilizing advanced clinical skills, the Care Coordinator facilitates the delivery of care, encompassing assessment, planning, intervention, and evaluation principles of the nursing process.

The Care Coordinator evaluates and promotes effective resource utilization by leveraging current clinical knowledge and awareness of community services. This position also assumes a leadership role within the patient care team to achieve optimal clinical and resource outcomes. Responsibilities include:

• Evaluating and analyzing quality/utilization cases, admission/discharge criteria, observation/1-day stays, readmissions within 30 days, Medicare, and diagnosis-related criteria.
• Participating in ongoing outlier reviews.
• Potentially working in the Emergency Department, collaborating with a multidisciplinary team to ensure the efficient and cost-effective care of patients during emergency episodes.
• Advocating for patients and families throughout the care continuum.
• Maintaining open communication as a resource for patients and families, facilitating interactions among providers, and monitoring services rendered.
• Remaining actively involved until the patient is discharged or transferred to another care setting.
• Initiating appropriate clinical pathways based on admission diagnoses and serving as a resource for utilization management purposes.

Minimum Requirements

• At least one year of recent case management experience in an acute care setting.
• Current California licensure.
• Current certification in CPR.

Shift Information

This position involves 8-hour shifts from 8:00 AM to 4:30 PM, with coverage required on both weekends and weekdays.

Holiday Coverage

No holiday coverage is required for this role.

Certifications

Required certifications include BLS/BCLS.