Case Manager Utilization Management - Unscheduled - Loma Linda

Job Description

**This is an unscheduled position** This position will support LLUBMC's strategic plan and the organization's mission to continue the teaching and healing ministry of Jesus Christ, while embracing the core values of Compassion, Integrity, Excellence, Teamwork, and Wholeness. Responsible for a variety of case management duties, thus assuring proper utilization providing maximum quality of patient care. Serves as a resource for staff in the area of Joint Commission standards and those of private utilization review agencies. The Case Manager is responsible for clinical evaluation and disposition of patients referred to the Loma Linda University Behavioral Medicine Center. Coordinates contact with the appropriate clinical, hospital and community resources. Coordinates with clinicians and hospital staff to facilitate hospital admissions. Performs other duties as needed.

Qualifications

Associate's Degree in Nursing required. Bachelor's degree in Nursing preferred. Minimum of one year of psychiatric, utilization review or quality assurance experience preferred. Current and unrestricted California RN license required. Certified Professional in Healthcare Quality preferred. Current BLS (Basic Life Support) certification and MAB course required within 90 days of hire. Ability to speak clearly in person and over the phone; ability to write clearly and concisely; ability to listen well and interact appropriately with patients, visitors, employees and outside agencies; ability to input data into computer. Must have diplomacy and tactfulness; must possess skills in negotiating, telephone usage, and written and verbal communication. Ability to work as a team member. Ability to develop positive therapeutic interactions with patient, patient families, co-workers, supervisors, medical staff and outside agencies; maintains calm demeanor in crisis situations; communicates clearly and effectively. Ability to maintain confidentiality. Ability to assess patients' conditions, interpret care plan, comprehend appropriate interventions, evaluate patient response to care, teach patients and families; requires higher level mental faculties accompanied by short and long-term memory; ability to concentrate on several assignments simultaneously, ability to organize and prioritize; ability to work with limited supervision; ability to execute duties in an efficient manner with attention to detail, ability to receive and accurately carry out instructions. Good problem solving skills with attention to details; ability to analyze and interpret data; requires analytical thinking skills accompanied by short and long-term memory; ability to work independently with minimal supervision. Excellent usage of English language and grammar. Knowledge of psychotropic medications. Knowledge of appropriate age group(s). Knowledge of Joint Commission, CMS and private payor guidelines and regulations. Age specific criteria pertinent to this position is contained and described within the department Performance Standards; additional criteria may be listed in separate documents by the department. Hours of duty may be irregular depending upon the needs of the department. **If in a recovery program, at least two years of sobriety is required for staff and at least 5 years for Management**

Company Overview

An outgrowth of the original Sanitarium on the hill in 1905, the present 11-story Loma Linda University Medical Center (LLUMC) opened on July 9, 1967. With the completion of the Loma Linda University Children's Hospital (LLUCH) in late 1993, nearly 900 beds are available for patient care, including at Loma Linda University Medical Center East Campus and Loma Linda University Behavioral Medicine Center (LLUBMC). Loma Linda University Health Care (LLUHC), a management service organization, supports the many programs and services provided by our 400+ faculty physicians. LLUMC operates some of the largest clinical programs in the United States in areas such as neonatal care and outpatient surgery and is recognized as the international leader in infant heart transplantation and proton treatments for cancer. Each year, the institution admits more than 33,000 inpatients and serves roughly half a million outpatients. LLUMC is the only level one regional trauma center for Inyo, Mono, Riverside, and San Bernardino counties.