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Case Manager II, Case Management, Sharp Chula Vista

Company: Sharp HealthCare
Location: Chula Vista
Posted on: October 12, 2020

Job Description:

Job Description Summary The Utilization Review RN Case Manager 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 position creates a balance between individual clinical needs with the efficient and cost effective utilization of resources while promoting quality outcomes. The Case Management department is an integrated department that includes Case Management, Social Services, Pastoral Care, Quality Improvement and Diabetes Management. Case Management works collaboratively with the healthcare team, social services and other disciplines to facilitate effective throughput, manage length of stay, as well assists with effective, safe and timely discharge planning. Sharp Chula VistaMedical Center is a 340+ bed hospital with the largest array of health careservices in San Diego's South Bay. ADesignated Planetree Person-Centered Care Hospital, Sharp Chula Vista is hometo the region's most comprehensive heart program and as well as offeringexceptional services for orthopedic care and women and infants. The Douglas & Nancy Barnhart CancerCenter offers patients the most advanced treatment technology, a unique healingenvironment and an extraordinary level of care. Sharp Chula VistaMedical Center has been providing health care to San Diego's South Baycommunity for more than 70 years. InJanuary 2020, we opened our new next-generation tower; the first new hospitalin the South Bay in more than 40 years. The new hospital tower at Sharp Chula Vista combines clinical excellencewith thoughtful consideration to provide the best level of care to the communitywe are privileged to serve. The NewTower has seven stories and adds 106 large, private patient rooms, including 10high-tech intensive care units along with six operating rooms, one of which isthe South Bay's first hybrid OR that can shift quickly from a catheterizationprocedure to surgery. There is also aredesigned main entrance and lobby; additional space for support services, includinga pharmacy and kitchen and a rooftop cafe with a panoramic ocean view. Location This position is located in Chula Vista, CA (San Diego County) Hours 8-hour day shift, 8:00 am - 4:30 pm; every other weekend Full-time (1.0 FTE), 80 hours per pay period Required Skills and Qualifications - Current unencumbered California Registered Nurse license - BSN or equivalent degree - Three years of recent acute care nursing experience or case management experience - Three years of recent case management, utilization review, care coordination experience - Advanced PC, data management and analysis skills - Understanding and knowledge of payer eligibility and reimbursement regulations and impact on the continuum of care - Knowledge of use of community resources to coordinate safe discharges from acute care and the ED settings - Excellent interpersonal skills, as demonstrated by the ability to work effectively with individuals and/or teams, and across disciplines - Excellent communication and negotiation skills, as demonstrated in oral and written forms - Ability to work in a collaborative partnership model with Social Workers and other members of the interdisciplinary team, both internal and external - Organizational and time management skills as evidenced by capacity to prioritize multiple tasks - Ability to mentor and lead a team Preferred Skills and Qualifications - Master's prepared RN - CM Certification - such as Accredited Case Manager (ACM) or Certified Case Manager (CCM) - Experience with InterQual and/or MCG and Allscripts 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, among other things, or status as a qualified individual with disability. Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, gender, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class.

Keywords: Sharp HealthCare, Chula Vista , Case Manager II, Case Management, Sharp Chula Vista, Executive , Chula Vista, California

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