ED Access Case Manager Care Management Per diem 7pm-730am
ED Access Case Manager Care Management Per diem 7pm-730am
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USD 73 - 73
1 Vacancy
Job Description
The RN Access Case Manager provides care coordination which emphasizes positive partnerships with nursing physicians and other key disciplines in order to coordinate admissions transfers and repatriation to PHDH through the emergency room or direct admission. The RN Access Case Manager works closely with insurance and various payor to coordinate and assist with reparation/transfer of outofnetwork patients from PHWH to the patients contracted facilities. The RN Access Case Manager performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity to achieve authorization and reimbursement for services for the appropriate level of care and status (Inpatient Observation Outpatient). RN Access Case Manager also provides oversight of hospital bed control system and work in collaboration with House Supervisor to ensure appropriate placement of patients to the right level of care. The RN Access Case Manager works to ensure appropriate utilization of hospital resources in all settings and levels of care.
PIH Health is a nonprofit regional healthcare network that serves approximately 3 million residents in the Los Angeles County Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital PIH Health Good Samaritan Hospital PIH Health Whittier Hospital 37 outpatient medical office buildings a multispecialty medical (physician) group home healthcare services and hospice care as well as heart cancer digestive health orthopedics womens health urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nations top hospital systems for best practices cuttingedge advancements quality of care and healthcare technology. For more information visit PIHHealth or follow us on Facebook Twitter or Instagram.
Required Skills
- Excellent verbal and written communication skills
- Thorough knowledge of hospital operations especially from an ER ICU nursing unit environmental
services and financial perspective. - Highly developed ability to multitask and maintain focus
- Proactive cando approach and desire to build positive working relationships through collaborative
problemsolving - Selfmotivated and results oriented. Must be able to demonstrate sound decision making flexibility
and prioritization skills. - Strong organizational skills
- Basic computer skills; Outlook Word and Excel
Required Experience:
Manager
Employment Type
Unclear
