RN Er
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Job Location:
Tustin, CA - USA
Hourly Salary:
$ 48 - 72
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
The RN Case Manager conducts clinical assessments of acute care inpatients to support utilization review resource management and safe discharge planning. Partners with the interdisciplinary team to coordinate timely costeffective care and smooth transitions across the continuum. Advocates for patient choice while respecting patient and family diversity. Monitors resource utilization and timeliness of services and completes admission continued stay and discharge reviews using approved criteria.
Our Values:
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What Youll Do
- Collaborates with patients families providers payers and community resources to coordinate transfers discharges transitions of care and posthospital services.
- Identifies appropriate levels of care based on medical necessity patient preferences stability and health plan benefits; provides referrals and resources as needed.
- Reviews medical necessity and length of stay using approved criteria; completes utilization review documents delays/avoidable days and escalates unresolved issues promptly.
- Partners with patients caregivers physicians and the multidisciplinary team to set goals and complete timely discharge planning assessments and documentation.
- Serves as a liaison to medical staff participates in patient/family meetings supports informed decisionmaking and contributes data to the Utilization Management Committee.
Qualifications
Required Qualifications:
- One year of case management experience or 1 year nursing leadership experience Current Licensure as a Registered Nurse in the State of California
- In-depth knowledge and strong understanding of patient throughput care coordination and care planning processes
- Ability to assess medical stability for discharge and evaluate medical necessity for continued acute hospitalization
- Computer/EMR Proficiency and Literacy
- Knowledge of CMS Medicare Medi-Cal and Managed Care reimbursement
- Familiarity of Joint Commission CMS CDPH requirements
- Excellent written and verbal communication skills in English
- Ability to establish and maintain effective working relationships across the organization
- Ability to facilitate and lead interdisciplinary rounds
Preferred Qualifications:
- Bachelor of Science in Nursing
- Certified Case Manager (CCM)
- Acute Hospital Case Management Experience
- Familiarity with AllScripts Care Management
- Proficiency with Milliman Care Guidelines or Interqual
- Bilingual skills to communicate effectively with patients and families
Environmental Job Requirements and Working Conditions
- The base pay range for this role is $48 - $72 per hour. This salary range represents our national target range for this role.
- This role follows an onsite work structure where the expectation is to work 5 days in office. The office is located at 14662 Newport Ave Tustin CA.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided based on qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
