RN Care Manager - Gastroenterology

Job Title

Responsible for the delivery of care coordination services for patients in the clinic setting.

Job Description

Is involved in the planning and delivery of family-centered patient care through a collaborative process including the patient and family, nurses, social workers, physicians, other practitioners, caregivers and the community. Engages in excellent communication, both verbal and written and facilitates care along the continuum. Advocates for and assist in the achievement of optimal health, access to care, and to utilize the appropriate resources. Provides a full range of nursing and assists in meeting the comprehensive care needs of the patients and their families. Eligible to be paneled by CCS to provide collaborative comprehensive care in a multidisciplinary setting. Demonstrates strong clinical knowledge and nursing expertise in the management of complex pediatric and specialty populations. Possesses excellent communication, collaboration, and relationship-building skills to effectively engage patients, families, providers, payers, community agencies, and interdisciplinary team members. Exhibits resilience, adaptability, and critical thinking while navigating complex healthcare systems, managed care requirements, and evolving patient needs. Utilizes leadership skills to influence care planning, facilitate problem-solving, support care coordination best practices, and promote quality patient outcomes. Serves as a patient and family advocate, fostering a patient-centered approach that supports equitable access to care, seamless transitions, and optimal health outcomes. Experience coordinating care for medically complex patients, including those with gastrointestinal conditions and within gastroenterology specialty practices, is preferred. Experience navigating managed care, chronic disease management, multidisciplinary care models, and community resources is highly desirable.

Pay Range

Minimum $52.93 Midpoint $70.13 Maximum $87.32

Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.

Experience

Required: Minimum two (2) years of experience in nursing within pediatric care or in an ambulatory setting.

Preferred: Three (3) plus years of nursing experience in an emergency department and/or case management, care coordination or transition of care; previous pediatric experience and/or management, and/or charge nurse roll acceptable.

Education

Required: Graduation with a Bachelor Degree in nursing from an accredited University.

Preferred: Master's Degree in Nursing from an accredited University.

Training

Required: None required.

Preferred: Certification in Case Management.

Specialized Skills

Required: Ability to work effectively under pressure due to changing priorities, interruptions, high/low census, payor demands and discharge planning demands; Excellent interpersonal communication, including conflict resolution, problem solving and negotiation skills; Clinical knowledge of multiple age groups, medical illness and treatment plans according to disease process, diagnosis and anticipated LOS; Strong organizational and time management skills, as evidenced by capacity to multi-task and prioritize; Ability to work independently and exercise sound judgment in interactions with physicians, payers, patients and their families; Demonstrates the knowledge and skills necessary to communicate with third party payers to obtain authorization for the appropriate treatment setting for patients requiring medical, psych and chemical dependency treatment; Must be proficient in required competencies upon completion of orientation and maintain annual departmental competency requirements; Ability to work collaboratively regardless of social, economic and cultural backgrounds; Computer knowledge to include skills in using Microsoft Office (Excel, Word, Power Point, Access)

Preferred: Knowledge of CCS/Medi-Cal regulations and requirements; Knowledge of third party payor requirements in order to optimize reimbursement; Ability to apply severity of illness/ intensity of service pediatric criteria to information extracted from clinical documentation; Bilingual

Licensure

Required: Basic Life Support (BLS); Registered Nurse - CA (RN).

Preferred: Certified Pediatric Nurse (CPN); Certified Case Manager (CCM); Commission for CM Certification (CCMC), Pediatric Advanced Life Support (PALS) Certification

Work Environments - Functional Demand:

Light - Moderate energy level Lift and carry 25-35 lbs. Push/pull 50-100 lbs. (ie. empty bed, stretcher).

Physical Activity Requirements:

Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation

Physical Activity Lifting

Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Occasional 0-35%

Sensory Requirements:

Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision

Environment Requirements:

Airborn Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations

Non-Discrimination Statement:

CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws. CHOC will consider for employment qualified applicants with criminal histories, in accordance with the Fair Chance Initiative for Hiring.

We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn't align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.

If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.