RN, Care Manager, Full-Time, Days, Hospital

$10,000 HIRING INCENTIVE AVAILABLE 

Job Requirements:

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Job Summary

• Exempt: No
• Collaborates with the patients and their families, the patient’s physicians, and care providers in
• coordinating the care of the patient, utilizing skills of advocacy, communication, management of fiscal
• and material management, regulatory compliance, and education. Identifies, facilitates and
• coordinates the appropriate services, resources, providers and facilities throughout the continuum of
• care. Acts as a liaison with physician(s) to assure all covered aspects of treatment are fully
• documented and ensure patients receive timely, appropriate care during their hospitalization. This position is represented by RCHEA. 

Standards of Behavior

Line of Responsibility and Authority

• LINE OF AUTHORITY: Case Manager-RN - Case Management Director

Licenses and Certifications

Professionalism and Self-Development

Education and Qualifications

• EDUCATION AND EXPERIENCE: Graduate from a BRN approved school of registered nursing; BSN preferred
• EDUCATION AND EXPERIENCE: Minimum of three years of clinical nursing experience: Preferred
• LICENSES OR CERTIFICATIONS: BLS Certification following American Heart Association guidelines required (no other cards accepted)
• LICENSES OR CERTIFICATIONS: Certified Professional in Healthcare Quality (CPHQ) or Certification in Case Management (CCM): Preferred
• LICENSES OR CERTIFICATIONS: Current California RN license required
• QUALIFICATIONS: Able to organize and maintain good follow-up
• QUALIFICATIONS: Able to work independently with minimal supervision
• QUALIFICATIONS: Excellent human relations and oral/written communications skills
• QUALIFICATIONS: Knowledge of current utilization/ continuing care principles, techniques, and procedures

Physical Requirements/Work Environment/Use of Senses and Communications Skills

• ACCOMMODATIONS: The physical demands and work environment characteristics described here are representative of those an employee typically encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the key responsibilities and essential functions
• CONFIDENTIALITY: Employee must conform with all HIPAA and other confidentiality regulations as required by the job, department, or hospital
• EQUIPMENT USED: Cell phone and pager
• EQUIPMENT USED: General office equipment, including computer, printer, calculator, copy machine and other office equipment
• PHYSICAL REQUIREMENTS (b): This job requires frequent bending, squatting, kneeling, climbing, reaching above shoulders, sitting, walking inclines and declines, standing, talking, hearing, and performing repetitive hand motions. Vision requirements include close vision and the ability to adjust focus. The employee will occasionally pull, lift, transfer, or push a patient side to side, to a sitting position, to a standing position, or laterally. The employee must demonstrate a pull lift of 50 pounds from the floor.
• POTENTIAL EXPOSURE TO BLOOD & BODY FLUIDS: Category 2 for potential exposure to blood/body fluids. (Does not usually require the performance of procedures or other tasks in the work routine that involve exposure to blood, body fluids or tissues, but Category 2 tasks may require the unexpected performance of these procedures.)

Job Roles

RN, Care Manager (AHCL)

• Appropriately delegates tasks and duties when directing and coordinating health care team members, patient care and activities.
• Assures completion of utilization review and management, including quality review, and case review for all third party payors including Medicare and Medi-Cal.
• Collaborates with the patient, responsible party/caregiver, nurse and attending physician in discharge planning and case management.
• Conducts initial review early in acute care admission on the identified targeted patient population for appropriateness of hospitalization. Monitors appropriate LOS on acute unit for identified patient popula