Case Manager*

Job Summary : The Case Manager serves as a key member of the patient care delivery team in a Magnet Recognized large tertiary academic medical center with level one trauma designation, STEMI receiving center, and Comprehensive Stroke and Chest Pain Center accreditation. The role involves working efficiently in a fast-paced environment, utilizing clinical expertise, discretion, and independent judgment in performing the nursing process (assessment, care planning, intervention, evaluation) within a patient-centered care model (Duffy's Quality-Caring Model) and case management functions. The Case Manager maintains a solid knowledge of specialized case and utilization management methodologies, ensuring medical appropriateness (medical necessity) criteria are met from admission through discharge. They practice collaboratively to oversee interdisciplinary care planning, including individualized discharge planning that addresses ongoing healthcare needs. The role requires reevaluating care plans based on patient condition changes and adhering to nursing excellence standards to achieve and maintain Magnet Recognition. The Case Manager acts as a change agent, embracing new knowledge and innovations, and participates in governance councils, committees, and staff meetings to influence practice. Additional duties are performed as needed, demonstrating leadership in implementing new processes to meet performance goals. Education and Experience : Bachelor's Degree in nursing required. Minimum of one year of patient care experience required. Two or more years of hospital case management or utilization management experience preferred. Knowledge and Skills : Basic knowledge of case and utilization management practices, healthcare regulations, and accreditation standards is required. Must be able to communicate effectively in English (Spanish preferred), operate necessary software and electronic medical records, and demonstrate professional behavior. Skills include critical thinking, independent work, organization, problem-solving, attention to detail, and effective communication. Licensures and Certifications : Active California RN license and BLS certification from the American Heart Association are required. Certification in Utilization Management or Case Management is preferred. Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork, and wholeness. #J-18808-Ljbffr Loma Linda University Health