Job Title: Care Manager RN
Employment Type: Full-Time
Job Summary
The
Care Manager RN plays a pivotal role in ensuring seamless patient care across a continuum, coordinating efforts between patients, caregivers, nurses, social workers, physicians, payers, and community practitioners. This position involves facilitating communication, care coordination, and effective transitional care management. The Care Manager RN will also focus on utilization management while respecting the patient’s right to self-determination and recognizing the complexities of care influenced by social determinants of health.
Key Responsibilities - Care Coordination:
- Collaborate with a multidisciplinary team, including patients, families, and healthcare professionals, to ensure continuity of care.
- Coordinate transitions of care across various settings (acute, post-acute, ambulatory, etc.) to avoid gaps and ensure appropriate care is provided.
- Perform utilization management to ensure that healthcare resources are used effectively and appropriately.
- Case Management:
- Develop individualized care plans for patients, considering their specific health needs, social conditions, and the complexities of their medical care.
- Ensure timely and appropriate discharge planning, facilitating communication between all stakeholders involved in the patient’s care.
- Utilization Management:
- Assess the necessity and efficiency of patient care services, ensuring appropriate resource utilization.
- Work collaboratively with healthcare providers to implement evidence-based clinical pathways and protocols.
- Transitional Care:
- Manage patient transitions between levels of care, ensuring the patient’s needs are met during every step of the care journey.
- Facilitate patient referrals to community resources, support services, and specialized care providers as needed.
Required Qualifications - Education:
- Bachelor’s Degree in Nursing or equivalent education/experience.
- Master’s Degree in Nursing or a healthcare-related field preferred.
- Exceptions for RNs with 20+ years of RN experience who will not be required to obtain a BSN.
- Specific contractual agreements regarding BSN acquisition may override the above stipulations.
- Licensure:
- California Registered Nurse License upon hire.
- Experience:
- 2 years of experience in a healthcare-related field (Acute, Ambulatory, Post-Acute, etc.).
- 2 years of experience in Case Management, including Care Coordination or Utilization Management, or successful completion of the Transitions in Practice (TIP) program for Care Managers.
- TIP candidates must have relevant nursing experience in the unit where the Care Manager position is available.
Preferred Qualifications - Certifications:
- Certified Case Manager (CCM) or Accredited Case Manager (ACM) certification upon hire is preferred.