RN Care Manager, CHOC Health Alliance
8 hour, Day, Full Time
The RN Care Manager is responsible for the delivery of care coordination services for patients admitted to an inpatient bed. Provides oversight for the inpatient care team which includes the case manager assistant and other members responsible for assisting patients and families with navigating the pediatric system of care. Reviews the formulated plan of care to facilitate the patient's care to care providers post discharge. Works collaboratively with the interdisciplinary team to ensure care is delivered in an efficient and cost-effective manner.
• Required: Minimum two (2) years of nursing experience in a pediatric acute care or ambulatory setting.
• Preferred: Three (3) years of nursing experience in an emergency department and/or case management, care coordination or transition of care. Previous pediatric experience and/or management, and/or charge nurse roll acceptable.
• Required: Bachelor’s degree from an accredited university.
• Preferred: Bachelor’s or master’s degree in healthcare related filed from an accredited university.
• Required: None required.
• Preferred: Certification in Utilization Review and/or Case Management.
• Required: Ability to work effectively under pressure due to changing priorities, interruptions, high/low census, payor demands and discharge planning demands. Excellent interpersonal communication, including conflict resolution, problem solving, and negotiation skills. Clinical knowledge of multiple age groups, medical illness and treatment plans according to disease process, diagnosis and anticipated LOS. Strong organizational and time management skills, as evidenced by capacity to multi-task and prioritize. Ability to work independently and exercise sound judgment in interactions with physicians, payers, patients, and their families. Demonstrates the knowledge and skills necessary to communicate with third party payers to obtain authorization for the appropriate treatment setting for patients requiring medical, psych and chemical dependency treatment. Must be proficient in required competencies upon completion of orientation and maintain annual departmental competency requirements. Ability to work collaboratively regardless of social, economic, and cultural backgrounds. Proficient skills in Microsoft Office e.g., Excel, Word, Power Point, Access.
• Preferred: Knowledge of CCS/Medi-Cal regulations and requirements. Knowledge of third-party payor requirements in order to optimize reimbursement. Demonstrate knowledge of third-party payor methods. Ability to apply severity of illness/ intensity of service pediatric criteria to information extracted from clinical documentation. Bilingual in English/ Spanish.
• Required: Basic Life Support (BLS); Ped Emerg Assess Recog & Stabil (PEARS); Registered Nurse - CA (RN).
• Preferred: Certified Pediatric Nurse (CPN); Certified Case Manager (CCM).
About the Hospital
Since 1964, CHOC has been steadfastly committed to providing the highest quality medical care to children. Affiliated with the University of California, Irvine, our regional pediatric healthcare network includes a state-of-the-art 334-bed main hospital facility in the City of Orange, and a hospital-within-a-hospital in Mission Viejo.