Prospect Medical Holdings, Inc.
RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
Prospect Medical Holdings, Inc., San Jose, California, United States, 95199
RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
Join to apply for the
RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
role at
Prospect Medical Holdings, Inc. RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
2 months ago Be among the first 25 applicants Join to apply for the
RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
role at
Prospect Medical Holdings, Inc. Get AI-powered advice on this job and more exclusive features. Prospect Medical Holdings, Inc. provided pay range
This range is provided by Prospect Medical Holdings, Inc.. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$51.20/yr - $70.40/yr Job Description
The RN Case Manager is responsible for performing clinical assessment and reassessment of acute care Inpatients for the purpose of performing utilization review, resource management and safe discharge planning. The RN Case Manager prioritizes, plans, organizes, and implements timeliness of care. Collaborates with the interdisciplinary healthcare team to promote and coordinate the delivery of safe and cost-effective patient care, transition of care and discharge planning. The RN Case Manager advocates for patient self-determination and choice. Practices clinical competence in evaluations and planning with awareness and respect for patient and family diversity. Monitors and coordinates resource utilization throughout the continuum of care and evaluates timeliness of services. Performs admission, continued stay and discharge review utilizing medical staff-approved decision support criteria.
Responsibilities
$25,000 Sign-on Bonus
Collaborates as needed with the patient and family to optimize client outcomes. May include work with community, local and state resources, primary care provider, and members of the health care team, payer, and other relevant health care stakeholders to facilitate appropriate patient transfers, discharges and transitions of care. Identifies timely and effective alternative lower level of care settings for patient care in accordance with the patient’s medical necessity, stability, the patients’ preferences and health plan benefits. Identifies timely post-hospital needs and arranges for services as appropriate. Provides patient and family appropriate resources and/or referrals. Makes timely and appropriate referrals to, and seeks consultation with others when needed, the patient-centered provision of services; such as Social Services (i.e., Durable Power of Attorney). Reviews medical necessity utilizing medical staff-approved evidence-based decision support criteria. to determine appropriate level of care and length of stay. Ensures utilization review is completed and documented concurrently, and provided to the patient’s payer as required. Ensures timely escalation of unresolved care coordination issues to the appropriate level. Enters delays in service and avoidable days regarding exceeded payer LOS variances. Communicates denials and physician related utilization management practices to immediate supervisor same day as identified. Collaborates with patients/caregivers to set goals consistent with physician treatment plans, and patient resources and choices. Collaborates with the multidisciplinary team for timely discharge planning assessments and reassessments and documents concurrently in the patient's medical record in compliance with hospital policy and all regulatory agencies. Provides appropriate instructions to discharge care coordinators as needed. Acts as an effective liaison to medical staff to ensure continuity and congruity of hospital services in accordance with the patient’s plan of care. Participates in patient and family meetings; respecting and promoting patient choice and documents informed decision making. Utilizes knowledge of psycho-social and physical factors that affect functional status on discharge. Contributes requested data for 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
Sign-on Bonus Eligibility:
To be eligible for the Sign-On Bonus, you must have one or more years of experience in the role for the position posted. Some restrictions and exceptions may apply. Current Hospital employees are not eligible and former Hospital employees may not be eligible. The Sign-on Bonus Program is only available for full-time regular positions. Bonus payments are made in increments over the course of 24 months to active employees in good standing.
Pay Rate: Min - $51.20 | Max - $70.40
$25,000 Sign-on Bonus
About Us
Southern California Hospital at Hollywood is a 100-bed acute care facility and 24/7 urgent care with a mission and vision to provide compassionate healthcare accessible to everyone. Southern California Hospital at Hollywood provides comprehensive, high-quality medical care. As an acute care facility, we have physicians and specialists on staff for the following: cardiology, pulmonology, internal medicine, psychiatry, orthopedics, hematology, endocrinology, podiatry, cardiothoracic vascular surgery, urology, plastic surgery, and more. Seniority level
Seniority level Entry level Employment type
Employment type Full-time Job function
Job function Health Care Provider Industries Hospitals and Health Care, Medical Practices, and Mental Health Care Referrals increase your chances of interviewing at Prospect Medical Holdings, Inc. by 2x Sign in to set job alerts for “Case Management Nurse” roles.
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Join to apply for the
RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
role at
Prospect Medical Holdings, Inc. RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
2 months ago Be among the first 25 applicants Join to apply for the
RN Case Manager - Loan Forgiveness - Full Time, Days (Hollywood)
role at
Prospect Medical Holdings, Inc. Get AI-powered advice on this job and more exclusive features. Prospect Medical Holdings, Inc. provided pay range
This range is provided by Prospect Medical Holdings, Inc.. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$51.20/yr - $70.40/yr Job Description
The RN Case Manager is responsible for performing clinical assessment and reassessment of acute care Inpatients for the purpose of performing utilization review, resource management and safe discharge planning. The RN Case Manager prioritizes, plans, organizes, and implements timeliness of care. Collaborates with the interdisciplinary healthcare team to promote and coordinate the delivery of safe and cost-effective patient care, transition of care and discharge planning. The RN Case Manager advocates for patient self-determination and choice. Practices clinical competence in evaluations and planning with awareness and respect for patient and family diversity. Monitors and coordinates resource utilization throughout the continuum of care and evaluates timeliness of services. Performs admission, continued stay and discharge review utilizing medical staff-approved decision support criteria.
Responsibilities
$25,000 Sign-on Bonus
Collaborates as needed with the patient and family to optimize client outcomes. May include work with community, local and state resources, primary care provider, and members of the health care team, payer, and other relevant health care stakeholders to facilitate appropriate patient transfers, discharges and transitions of care. Identifies timely and effective alternative lower level of care settings for patient care in accordance with the patient’s medical necessity, stability, the patients’ preferences and health plan benefits. Identifies timely post-hospital needs and arranges for services as appropriate. Provides patient and family appropriate resources and/or referrals. Makes timely and appropriate referrals to, and seeks consultation with others when needed, the patient-centered provision of services; such as Social Services (i.e., Durable Power of Attorney). Reviews medical necessity utilizing medical staff-approved evidence-based decision support criteria. to determine appropriate level of care and length of stay. Ensures utilization review is completed and documented concurrently, and provided to the patient’s payer as required. Ensures timely escalation of unresolved care coordination issues to the appropriate level. Enters delays in service and avoidable days regarding exceeded payer LOS variances. Communicates denials and physician related utilization management practices to immediate supervisor same day as identified. Collaborates with patients/caregivers to set goals consistent with physician treatment plans, and patient resources and choices. Collaborates with the multidisciplinary team for timely discharge planning assessments and reassessments and documents concurrently in the patient's medical record in compliance with hospital policy and all regulatory agencies. Provides appropriate instructions to discharge care coordinators as needed. Acts as an effective liaison to medical staff to ensure continuity and congruity of hospital services in accordance with the patient’s plan of care. Participates in patient and family meetings; respecting and promoting patient choice and documents informed decision making. Utilizes knowledge of psycho-social and physical factors that affect functional status on discharge. Contributes requested data for 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
Sign-on Bonus Eligibility:
To be eligible for the Sign-On Bonus, you must have one or more years of experience in the role for the position posted. Some restrictions and exceptions may apply. Current Hospital employees are not eligible and former Hospital employees may not be eligible. The Sign-on Bonus Program is only available for full-time regular positions. Bonus payments are made in increments over the course of 24 months to active employees in good standing.
Pay Rate: Min - $51.20 | Max - $70.40
$25,000 Sign-on Bonus
About Us
Southern California Hospital at Hollywood is a 100-bed acute care facility and 24/7 urgent care with a mission and vision to provide compassionate healthcare accessible to everyone. Southern California Hospital at Hollywood provides comprehensive, high-quality medical care. As an acute care facility, we have physicians and specialists on staff for the following: cardiology, pulmonology, internal medicine, psychiatry, orthopedics, hematology, endocrinology, podiatry, cardiothoracic vascular surgery, urology, plastic surgery, and more. Seniority level
Seniority level Entry level Employment type
Employment type Full-time Job function
Job function Health Care Provider Industries Hospitals and Health Care, Medical Practices, and Mental Health Care Referrals increase your chances of interviewing at Prospect Medical Holdings, Inc. by 2x Sign in to set job alerts for “Case Management Nurse” roles.
San Jose, CA $105,200.00-$132,600.00 4 days ago San Jose, CA $106,000.00-$233,000.00 2 days ago Sunnyvale, CA $120,000.00-$200,000.00 4 months ago Registered Nurse School Setting in Sunnyvale, CA
Campbell, CA $2,677.74-$2,677.74 2 days ago School Registered Nurse | Santa Clara, California
Travel Registered Nurse Cardiac Cath Lab
Mountain View, CA $3,005.16-$3,005.16 6 hours ago School Registered Nurse | Santa Clara, California
School-Based Registered Nurse (RN) - Sunnyvale, California
Registered Nurse - Assistant Manager Cath Lab
Pleasanton, CA $98,260.00-$205,260.00 2 months ago Registered Nurse School Setting in San Jose, CA
Registered Nurse (RN) ICU Full Time Nights
Registered Nurse School Setting in Morgan Hill, CA
Registered Nurse II, Women’s Health OBGYN Triage, Advice & Fetal Monitoring
Pleasanton, CA $98,260.00-$205,260.00 2 weeks ago San Jose, CA $124,000.00-$165,000.00 2 weeks ago Redwood City, CA $130,000.00-$160,000.00 2 months ago Pleasanton, CA $98,260.00-$205,260.00 3 months ago Registered Nurse – Medical Surgical - Travel - (MS RN)
Fremont, CA $130,000.00-$160,000.00 1 week ago Home Health Registered Nurse (RN) - San Jose
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr