Case Manager, RN

Join Henry Mayo Newhall HospitalYour work here matters. Your career here thrives. Imagine coming to work every day knowing that what you do genuinely changes lives. At Henry Mayo Newhall Hospital, that's not just a tagline — it's the reality for every member of our team.We're not just a hospital. We're the heartbeat of the Santa Clarita Valley — a 357-bed, not-for-profit Level II Trauma Center that has been a trusted pillar of this community since 1975. And we're looking for passionate, driven professionals who want to be part of something bigger than themselves.Where clinical excellence meets cutting-edge careHere, you'll work alongside an award-winning team delivering some of the most advanced medical services in the region, including:Comprehensive heart and vascular careAdvanced stroke treatmentCancer care in partnership with Keck Medicine of USCWomen's imaging and breast health servicesEmergency and trauma careCardiac rehabilitation and wellness programsAs a key part of Los Angeles County's STEMI receiving network, we provide lifesaving cardiac intervention through our state-of-the-art Roberta G. Veloz Cardiac Cath Lab. We continuously invest in the latest technology and innovation — which means you'll always be working at the forefront of modern medicine.A culture you'll be proud to be part ofOur vision — To Be the Most Patient-Centric Hospital Anywhere — drives everything we do. But it's our people who make that vision a reality. Physicians, nurses, staff, and volunteers come together here in a culture rooted in compassion, collaboration, and excellence.When you join Henry Mayo, you're not just accepting a job offer. You're joining a family that genuinely cares — about our patients, our community, and you.Located in beautiful Valencia, CaliforniaNestled in the vibrant Santa Clarita Valley, you'll enjoy an exceptional quality of life both inside and outside of work — with top-rated schools, scenic surroundings, and a welcoming community that generations of families proudly call home.Ready to make your mark? Join the team that's been setting the standard for compassionate, innovative healthcare for nearly 50 years. Your next great chapter starts here.Job SummaryThe RN Case Manager is responsible for coordination of care, utilization review, acting as a resource to patient, family and nursing units; referrals to clinical social worker for psycho-social issues and complicated discharge planning issues; and overseeing coordination of post-hospital care needs; interacting with insurance companies, medical groups, and community resources to ensure timely, efficient use of all services. Applies knowledge of the expected clinical process, available resources, medical necessity criteria, regulatory requirements, and relevant standards of care in anticipating patient needs. Responsible for case management across the continuum of care utilizing an interdisciplinary approach to managing patient throughput in a fiscally responsible manner to achieve optimal outcomes. Works as a member of a multidisciplinary team to actively facilitate those functions associated with the patient throughout an acute episode of care.What You'll Bring to the Team: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 relationshipsExcellent organizational skills and the ability to problem solve are essentialStrong interpersonal skills, leadership, negotiation skills, good leadership talentKnowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essentialAbility to work independentlyLicensure and Certification:Current CA RN licenseCurrent BLS provider cardCase Management certification preferredEducation:Diploma, AA, BS in NursingMS in Nursing preferredExperience:Two (2) years as a Case Manager in an acute care setting or five years recent acute care nursing experience 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.Knowledge of InterQual and/or Milliman preferred