Position Overview

This Case Manager II role is dedicated to coordinating healthcare services to optimize patient outcomes. The position involves comprehensive assessment, evaluation, collaboration, and coordination of patient care delivery systems, with active participation in designated service line activities. Emphasis is placed on cost-effective strategies that ensure high-quality care within the evolving healthcare landscape for the targeted patient population.

Key Responsibilities

• Patient Care:
  • Perform thorough assessments to identify patient needs and develop personalized discharge plans.
  • Coordinate services to maximize patient outcomes effectively.
  • Collaborate with healthcare teams and participate in service line initiatives.
  • Manage utilization review, discharge planning, and other healthcare systems.
  • Serve as a liaison and advocate for patients, families, healthcare providers, and insurance personnel.
  • Maintain patient dignity and confidentiality while demonstrating empathy and compassion.
  • Promote evidence-based practices in case management and utilization review.
• Safety and Compliance:
  • Ensure a safe and clean work environment adhering to infection control and institutional policies.
  • Comply with regulatory standards such as The Joint Commission and OSHA.
  • Proactively identify and report safety concerns.
  • Implement cost-efficient strategies that uphold quality care standards.
• Documentation:
  • Accurately document assessments and patient interactions in the Electronic Health Record (EHR) following departmental standards.
• Professional Development and Leadership:
  • Provide mentorship and preceptorship to new graduate nurses, new hires, and students to support their growth.
  • Engage in continuing education and quality improvement projects.
  • Act as a resource for best practices within case management.
• Emergency Preparedness:
  • Activate emergency response protocols during patient emergencies, including Rapid Response Team situations.

Qualifications

• Minimum of two years’ experience as a Registered Nurse in case management or utilization management.
• Familiarity with Prospective Payment System and regulatory requirements related to Utilization Management and Discharge Planning.

Competencies

• Technical Skills: Proficient with computer applications including Word; knowledge of various payer types; experience with referral management systems preferred.
• Critical Thinking: Ability to make rapid decisions and adjust plans as needed; strong prioritization skills.
• Communication: Effective verbal and written communication with patients, families, and multidisciplinary teams; strong interpersonal skills fostering collaboration.

Education

• Bachelor of Science in Nursing (BSN) required, or Associate Degree in Nursing (ADN) with five years of case management experience in lieu of BSN.

Licenses and Certifications

• Current Registered Nurse license required.
• Accredited Case Manager (ACM), Certified Case Manager (CCM), or equivalent certification preferred.

All candidates must successfully complete a physical evaluation, drug screening, and background checks prior to employment.

This opportunity is located in a vibrant regional healthcare setting within the Pacific Southwest region of the United States.