Registered Nurse, ED Access Case Manager
The RN Access Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to coordinate admissions, transfers and repatriation to PHDH through the emergency room or direct admission. The RN Access Case Manager works closely with insurance and various payor to coordinate and assist with reparation/transfer of out-of-network patients from PHWH to the patient’s contracted facilities. The RN Access Case Manager performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity to achieve authorization and reimbursement for services for the appropriate level of care and status (Inpatient, Observation, Outpatient). RN Access Case Manager also provides oversight of hospital bed control system and work in collaboration with House Supervisor to ensure appropriate placement of patients to the right level of care. The RN Access Case Manager works to ensure appropriate utilization of hospital resources in all settings and levels of care.
- Excellent verbal and written communication skills
- Thorough knowledge of hospital operations especially from an ER, ICU, nursing unit, environmentalservices and financial perspective.
- Highly developed ability to multi-task and maintain focus
- Proactive, can-do approach and desire to build positive working relationships through collaborative problem-solving
- Self-motivated and results oriented.
- Must be able to demonstrate sound decision making, flexibility and prioritization skills.
- Strong organizational skills
- Basic computer skills; Outlook, Word and Excel
- Maintain an active California RN License.
- Obtain ACM (Accredited Case Manager) or CCM (Certified Case Manager) within 3 years of hire.
- Minimum of five (5) years of acute hospital nursing experience.
- LA City Fire card within 6 months of employment (PHGSH only)
About the Hospital
Come to Good Samaritan for a richness of experience beyond the practice of exceptional medicine. With a multi-cultural staff of more than 1,600 employees and 650 physicians, we offer opportunities to work and grow among people from a wide variety of cultures, backgrounds and traditions.