Care Manager I, Registered Nurse
Company: Sutter Health
Posted on: May 11, 2022
Position Overview:The RN Case Manager is responsible for Care
Coordination, Care Transitions, Discharge Planning and Utilization
Management throughout the acute care patient experience. - The RN
Case Manager works in collaboration with the Physician, Medical
Social Worker and bedside RN to assure the timely movement of
patients to the appropriate level of care to prevent unnecessary
admissions or readmissions. - - Oversees the management of acute
patient populations across the care continuum with the primary
focus to provide coordinated, timely and integrated care. The RN
Case Manager reports to either the Supervisor or Manager or
Director of Care Coordination in each facility. The RN Case Manager
has frequent contact with patients, families, physicians, the
interdisciplinary team, nursing management, quality, ancillary
services, third party payers and review agencies, claims and
finance departments, Medical Directors, and contracted providers
and community resources. -Qualifications:Education:
- BS in one of following: - Nursing or Health related field. -
Master in nursing, case management or other health related field
- National Certification in Case Management (i.e. ACM, ANA RN-BC
Case Management) preferred.
- Current California RN licensure required.Experience:
- Minimum of three (3) years in acute medical/surgical/ED/or
critical care nursing area required. - Masters of Nursing in Case
Management in lieu of three (3) years in acute
medical/surgical/ED/or critical care nursing area may be considered
for employment at director's discretion.
- Previous Case Management experience preferred.
- Experience utilizing electronic InterQual or other standardized
criteria strongly preferred.
- Experience with clinical assessment for patient with complex
medical, emotional and social needs.
- Experience using an electronic medical record system.
- Experience and knowledge with MIDAS preferred. -Knowledge:
- Excellent interpersonal communication and negotiation
- A broad knowledge base of health care delivery and case
management within a managed care environment.
- Comprehensive knowledge of Utilization Review, levels of care,
and observation status
- Some awareness of healthcare reimbursement systems: HMO, PPO,
- Post-acute levels of care such as Home Health, Hospice, AIM,
and Palliative Care. SNF, LTAC, B&C, Sub-acute, Acute
- General Knowledge of coding and DRG assignment process
- Must be able to effectively communicate with, and promote
cooperation and collaboration between individuals including
patients/families/caretakers, physicians, nurses and other
- Ability to work independently and exercise sound judgment in
interactions with physicians, payers, and patients and their
- Demonstrates commitment to service excellence in all patient,
family and employee interactions and in performing all job
- Functions in a manner to promote quality patient care and
assure a positive patient experience.
- Excellent verbal and written communication skills.
- Must have excellent time management skills to develop organized
work processes in a high-volume environment with rapidly changing
- Intermediate computer skills.
- Ability to promote teamwork and to effectively function in
- Ability to interact effectively with key internal and external
constituents using collaboration, and customer service skills that
promote excellence in the patient
experience.Organization:California Pacific Medical CenterEmployee
Status: RegularEmployee Referral Bonus: NoBenefits: YesPosition
Status: Non-ExemptUnion: YesJob Shift: DayShift Hours:8 Hour
ShiftDays of the Week Scheduled:Monday-FridayWeekend Requirements:
RotatingSchedule: Full TimeHrs Per 2wk Pay Period:80Applications
Accepted:All Applications AcceptedSchedule/Shift: Full Time/
Keywords: Sutter Health, Novato , Care Manager I, Registered Nurse, Executive , Novato, California
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