RN Case Manager position at Oceans Medical Staffing inc in Orange

Oceans Medical Staffing inc is hiring RN Case Manager on Mon, 02 Sep 2013 18:58:13 GMT. Job Summary: This position uses clinical knowledge, experience and licensures to create individualized care plans for the most clinically ill and special needs patients. Responsibilities include: clinical needs assessment, care plan development, and continuous monitoring using independent decision making as patient needs are prioritized. The goal is to promote quality, cost effective care...

RN Case Manager

Location: Orange California

Description: Oceans Medical Staffing inc is hiring RN Case Manager right now, this position will be placed in California. For detail informations about this position opportunity please read the description below. Job Summary:
This position uses clinical knowledge, experience and licensures to create individualized care plans for the most clinically ill and special needs patients. Responsibilities include! : clinical needs assessment, care plan development, and continuous monitoring using independent decision making as patient needs are prioritized. The goal is to promote quality, cost effective care management throughout the health care continuum including monitoring all care transitions.

Essential Functions:
§ Manages a caseload of high risk, high cost, complex and/or catastrophic patients by assessing the individual’s health care needs and monitors patient progress by modifying plan of care as necessary. This is accomplished, in coordination with the health care team, patient, family and providers according to departmental standards. 30%
§ Monitors planned and unplanned transitions of care involving health plan, facility discharge planner, physician, family and members of the Management Team. 20%

Collaborates with physicians, patients and family members to formulate an optimal treatment plan that will meet all the medical, psycho-social! , physical and financial needs of the individual 15% Maintains! files and documentation according to specialty care management departmental standards.10%
Manages and approves referral authorizations for patients using principles of appropriate utilization management according to department standards, policies/procedures, and evidenced based care management systems.10% . .
Utilizes knowledge of alternative funding sources, benefits plans, and contractual information to promote appropriate quality, and cost effective care for patients who meet specialty case management referral criteria . 5%
§ Maintains cost-savings, patient status log and reports statistics monthly, as requested. 5%
§ Assumes the role of advocate to support and assist the patient and family. 5%

Additional Responsibilities:
Other duties may be assigned as needed.

Knowledge / Skills / Abilities: (Identify traits, skills that will narrow identify best incumbents)
Knowledge of utilization management, case management ! and healthcare provided throughout the continuum.
Ability to use critical thinking skills to perform independent problem solving

• Ability to handle multiple tasks at a time and remain organized.
• Ability to work autonomously but also as a team member.

Age-Related Competencies:

• Human development knowledge/skills:

Demonstrates the knowledge and skills necessary to develop age appropriate clinical assessments and care plans for the patients we serve. This includes having knowledge of the principles of growth and development and psychosocial characteristics and interventions for infant (0-1 year), child (1-5 years), school age (6-12 years), adolescent (13-17 years), young adult (18-45 years), middle adult (46-60 years), older adult (60+ years).

• Age-specific patient needs that employee is required to understand and meet:

Demonstrates the ability to assess and interpret age appropriate ! data about the patient’s status in order to identify age-specific nee! ds and provide the care needed.

• Additional requirements:

Demonstrates age appropriate communication skills for the patient population served.
Demonstrates knowledge of age-specific community resources.

Information Management:
Treats all information and data within the scope of the position with complete confidentiality and security.

Risk Management:
Cooperates fully in all risk management activities and investigations .

Safety Requirements:
Is knowledgeable of, observes and will comply with office and hospital Codes of Safe Practice, safety
policies and emergency procedures.

Minimum Position Qualifications:

• Education: Graduate of RN Accredited School of Nursing
• Experience: 3 years experience in utilization management and/or case management with a Health Plan across commercial and Medicare Advantage lines of business.
• Training: Minim! um of 3 years clinical experience in hospital or medical office/clinic setting.
• License/Certification: Active California Registered Nurse license.

Preferred Position Qualification:

• Bachelor of Science in Nursing (BSN)
• Certification in Utilization Review (CPUR)
• Certification in Case Management (CCM) or commensurate years of experience
• Specialty Certification in Oncology, Rehab, Pediatrics, Transplant or Wound Care.
• Proficiency in Excel, Access, and Word computer applications.

Environmental Conditions:
Complies with OSHA requirements.

Physical Requirements:
Additional physical requirements are defined on the attached Physical Demand Analysis.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to Oceans Medical Staffing inc.

If you interested on this position just click on the Apply button, you will be redirected to the official website

This position starts available on: Mon, 02 Sep 2013 18:58:13 GMT

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