RN Case Manager – Value Based Service Organization

Job Description

In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a consultant to members of the health care team in the management of specific patient populations.

The role integrates the functions of complex case management, utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services, including transfers to an alternative level of care. As more complex medical treatment options emerge the Case Manager will look to eliminate gaps in the care provided, as well as needlessly duplicated treatment, all while controlling the cost of quality patient care.

The Case Manager will leverage their clinical and social work experience to ring an understanding of the clinical process of assessment, planning, implementation, and evaluation to the process of case management. Some of the major duties of a Case Manager include: Documenting patients' case management plans and on-going activities; Identifying patients 'insurance coverage or other sources of payment for services; Identifying and addressing patient risk factors and/or obstacles to care; Identifying patient needs, current services, and available resources, then connecting the patient to services and resources to meet established goals; Communicating the care preferences of patients, se…

Qualifications

Required Qualifications:

• Req Associate’s Degree Nursing
• Req 5 years Clinical experience
• Req 2 years Ambulatory case management or utilization review experience within the last three years
• Req Ability to work independently with minimal supervision, exercising judgment and initiative.Req Ability to manage multiple tasks with effective prioritization.
• Req Process oriented.
• Req Good computer skills.

Preferred Qualifications:

• Pref Bachelor’s Degree Nursing
• Pref 2 years Experience in an HMO/IPA/Managed care setting

Required Licenses/Certifications:

• Req Registered Nurse - RN (CA DCA)
• Req Basic Life Support (BLS) Healthcare Provider from American Heart AssociationReq Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only).

About the Hospital

At Keck Medicine of USC, diversity means recognizing the richness of our differences and celebrating them together.

Our nurses enjoy a wide array of competitive benefits, including free tuition at USC for both employees and their families.

We provide exceptional healthcare, retirement benefits and quality of life programs designed to help you make the most of your experience at Keck Medicine of USC; and discounts on a wide variety of services, including public transportation passes, campus fitness center memberships and event tickets.