RN CASE MANAGER (WHITTIER) FULL TIME, DAYS (8:30 AM - 5:00 PM - Varies including Weekends)Apply Now Job ID 7331-977 Date posted 03/26/2019
We’re a nonprofit, regional healthcare network with two hospitals, numerous outpatient medical offices, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer and emergency services. Our leadership is dedicated to putting patients first—a cornerstone of our mission, vision and values—as we deliver top-quality healthcare.
From our extensive facilities in Whittier, California and Downey, California, PIH Health serves more than two million residents in Los Angeles and Orange Counties and throughout the San Gabriel Valley.
The RN Case Manager II provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace the care for outcomes while meeting core measures within the appropriate level of care. The RN Case Manager II provides discharge planning by collaboratively determining level of care needs beyond acute care, providing decision support to patients and families and physicians, managing patient and family expectations and ensuring a smooth transition to the next level of care and services. The RN Case Manager II performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity, physician documentation and knowledge of ICD 10 to achieve reimbursement for services and ensuring appropriate utilization of hospital resources.
- Excellent verbal, written, and organizational skills required.
- Ability to follow chain of command.
- Knowledge of medical terminology and current third party payor reimbursement methodologies.
- Self-motivated and results oriented.
- Must be able to demonstrate sound decision making and prioritization skills.
- Proficiency with main-frame and personal computers.
Maintain an active California RN License.
- Obtain ACM (Accredited Case Manager) or CCM (Certified Case Manager) within 3 years of hire.
- Meet one of the following combinations of education and experience:
- ADN degree with minimum of 10 years acute hospital nursing experience
- BSN degree with minimum of 6 years acute hospital nursing experience
- MSN degree with minimum of 2 years acute hospital nursing experience
- CCM or ACM (Certified Case Manager, Accredited Case Manager)
- Previous experience in case management.
Beyond the benefits that come with working for the area's leading community healthcare provider – one that also recognizes the need to ensure patient safety and comfort – you'll enjoy an extremely competitive compensation and benefits package. We are an equal opportunity employer and seek diversity in our workforce. EOE M/F/D/V