Sharp HealthCare
Case Manager II - Transition Planning - Sharp Memorial Hospital - FT - Days
Sharp HealthCare, San Diego, California, United States, 92189
Case Manager II – Transition Planning – Sharp Memorial Hospital – FT – Days
Apply to join Sharp HealthCare.
Hourly Pay Range (Minimum – Midpoint – Maximum): $67.860 – $78.740 – $89.620
What You Will Do The RN CM II assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the appropriate setting and level of care. The role creates a balance between individual clinical needs with the efficient and cost‑effective utilization of resources while promoting quality outcomes. The CM II will partner with ICM leadership to mentor and precept new hires (CMI, SW, LVN Care Coordinators and CRCs).
Required Qualifications
Bachelor's Degree in Nursing or equivalent degree.
2 years recent pertinent clinical experience as defined by the CBA.
3 years acute care nursing experience or case management experience.
3 years case management, utilization review, care coordination experience.
California Registered Nurse (RN) - CA Board of Registered Nursing.
Preferred Qualifications
Master's Degree.
Certified Case Manager (CCM) – Commission for Case Manager Certification (PREFERRED).
Accredited Case Manager (ACM) – American Case Management Association (ACMA) (PREFERRED).
Essential Functions
Professional development: Actively participate in performance planning, competency and individual development planning. Maintain current knowledge of case management, utilization management and discharge planning as specified by Sharp, federal, state and private insurance guidelines.
Core principles: Make timely referrals to ensure patient receives appropriate care in the appropriate setting and using appropriate utilization standards. Ensure patients from all age groups proceed efficiently through hospitalization and beyond through the continuum of care. Relate and communicate positively, effectively and professionally; be assertive and consistent in following policies; lead, supervise, teach, collaborate and accept direction.
Organizational relationships: Work closely with the healthcare team to reach unit, facility, and system goals including reductions in length of stay, decreasing denials, improving care transitions and reducing avoidable readmissions.
Knowledge, Skills, and Abilities
Advanced PC, data management and analysis skills required.
Understanding of payer eligibility and reimbursement regulations and impact on the continuum of care.
Knowledge of using community resources to coordinate safe discharges from acute care and ED settings.
Excellent interpersonal skills, demonstrated by effective teamwork across disciplines.
Excellent communication and negotiation skills in oral and written form.
Ability to work collaboratively with Social Workers and other interdisciplinary team members.
Organizational and time‑management skills evidence by capacity to prioritize multiple tasks.
Ability to mentor and lead a team.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran or any other protected class.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Other
Industry Hospitals and Health Care
#J-18808-Ljbffr
Hourly Pay Range (Minimum – Midpoint – Maximum): $67.860 – $78.740 – $89.620
What You Will Do The RN CM II assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the appropriate setting and level of care. The role creates a balance between individual clinical needs with the efficient and cost‑effective utilization of resources while promoting quality outcomes. The CM II will partner with ICM leadership to mentor and precept new hires (CMI, SW, LVN Care Coordinators and CRCs).
Required Qualifications
Bachelor's Degree in Nursing or equivalent degree.
2 years recent pertinent clinical experience as defined by the CBA.
3 years acute care nursing experience or case management experience.
3 years case management, utilization review, care coordination experience.
California Registered Nurse (RN) - CA Board of Registered Nursing.
Preferred Qualifications
Master's Degree.
Certified Case Manager (CCM) – Commission for Case Manager Certification (PREFERRED).
Accredited Case Manager (ACM) – American Case Management Association (ACMA) (PREFERRED).
Essential Functions
Professional development: Actively participate in performance planning, competency and individual development planning. Maintain current knowledge of case management, utilization management and discharge planning as specified by Sharp, federal, state and private insurance guidelines.
Core principles: Make timely referrals to ensure patient receives appropriate care in the appropriate setting and using appropriate utilization standards. Ensure patients from all age groups proceed efficiently through hospitalization and beyond through the continuum of care. Relate and communicate positively, effectively and professionally; be assertive and consistent in following policies; lead, supervise, teach, collaborate and accept direction.
Organizational relationships: Work closely with the healthcare team to reach unit, facility, and system goals including reductions in length of stay, decreasing denials, improving care transitions and reducing avoidable readmissions.
Knowledge, Skills, and Abilities
Advanced PC, data management and analysis skills required.
Understanding of payer eligibility and reimbursement regulations and impact on the continuum of care.
Knowledge of using community resources to coordinate safe discharges from acute care and ED settings.
Excellent interpersonal skills, demonstrated by effective teamwork across disciplines.
Excellent communication and negotiation skills in oral and written form.
Ability to work collaboratively with Social Workers and other interdisciplinary team members.
Organizational and time‑management skills evidence by capacity to prioritize multiple tasks.
Ability to mentor and lead a team.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran or any other protected class.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Other
Industry Hospitals and Health Care
#J-18808-Ljbffr