Explore jobs
Find specific jobs
Explore careers
Explore professions
Best companies
Explore companies
Registered Nurse Case Manager jobs at MemorialCare
- 353 jobsRN, Case Manager III (UR)
Memorialcare
Registered nurse case manager job at MemorialCare
RN, Case Manager III (UR) - (LON014835) Description Title RN Case Manager IIILocation Long BeachDepartment Care CoordinationStatus Full time Shift DayPay Range $59. 87/hr - $83. 39/hr$20,000 signing bonus available to external hires new to MHS employment, contingent upon satisfaction of employment requirements. At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position SummaryThe Case Manager III is a licensed professional who plans, coordinates and facilitates the ongoing care and appropriate discharge plan of a specific caseload of patients through the continuum of care. The case manager III collaborates with members of the health care team, the patient, and their family to assure effective, efficient, and appropriate care and outcomes. The incumbent is accountable for education, monitoring, utilization and evaluation of medical outcomes. Essential Job Outcomes & Functions Care ManagementCase ManagementThe case manager III independently manages a specific case load of patients as identified by the Resource Management Department and CareLines. The case manager analyzes patient information and assess each patient's functional status and decision making ability in relation to the continuum of care and discharge needs. The case manager collaborates with the health care team, patient, and family in planning and facilitating the achievement of expected outcomes for patients. Each treatment plan is evaluated for appropriate quality outcomes and utilization of resources. Continuum of Care/QualityThe case manager III works collaboratively with the health care team to provide education, resources, and referrals as needed for each patient and their family or caretaker. The case manager facilitates coordination among health care professionals, services, and settings involved in the patient's care, with a focus on enhancing patient satisfaction. The case manager actively communicates with nursing leadership, CareLine physician directors, and Medical Directors on quality issues. As appropriate, concerns are referred to various Medical Staff Committees and CareLines through required documentation, including but not limited to the Clinical Pertinence Review Form. The case manager has the responsibility to maintain professionalism and provide ongoing education to the health care team regarding the case manager's role. Utilization ManagementThe case manager works collaboratively and proactively with payors in managing patient resources. The case manager assures the hospital receives appropriate reimbursement through collaboration with the health care team and provides timely clinical review, as well as retroactive review for unbilled accounts. The case manager utilizes the billing system to analyze charges vs. reimbursement and contract information. This information is used to structure the health care team toward effective utilization of resources. The case manager incorporates knowledge of medical necessity, CareLine protocols, and MAPs to evaluate for appropriateness of admissions, continued stay, and discharges. The case manager refers cases, as appropriate, for review to the Combined Resource Management Committee and other Medical Staff Committees as needed. Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare-that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there's more. . . Check out our MemorialCare Benefits for more information about our Benefits and Rewards. Qualifications ExperienceThis position requires strong verbal and written communication skills with the ability to communicate well with people from diverse socioeconomic backgrounds. The case manager is knowledgeable of criteria for medical necessity for each level of care through the continuum of care. A knowledge of reimbursement related to MediCare, MediCal, Capitation, and Managed Care is required. Three to five years acute care or home health experience plus prior experience in Quality Improvement, Case Management, Discharge Planning or Utilization Management required. Education Current California RN License. BSN or Bachelors degree in health or related field preferred Primary Location: United States-California-Long BeachJob: Case Mgmt, Utilization ReviewOrganization: Long Beach Memorial Medical CenterSchedule: Full-time Employee Status: RegularJob Level: StaffJob Posting: Dec 3, 2025, 4:23:27 PMWork Schedule: 8/80 work shift hours (hospital) Union Code: CNAShift: Day JobDepartment Name: Care Coordination$59.9-83.4 hourly Auto-Apply 12d agoCase Manager II, Registered Nurse
Sutter Health
Burlingame, CA jobs
We are so glad you are interested in joining Sutter Health! Organization: Bay Administration Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating in a timely and integrated fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. When assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions. Job Description: EDUCATION: Graduate of an accredited school of nursing CERTIFICATION & LICENSURE: RN-Registered Nurse of California Upon Hire CCM certification preferred TYPICAL EXPERIENCE: 5 years recent relevant experience. SKILLS AND KNOWLEDGE: A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of care, and observation status. Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, value-based reimbursement models, and alternative payment systems preferred. Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, CDPH and TJC. A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements. General understanding of coding and DRG assignment process preferred. Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. Demonstrates commitment to service excellence in all patients, family and employee interactions and in performing all job responsibilities. Functions in a manner to promote quality patient care and assure a positive patient experience. Strong verbal and written communication skills and negotiation skills Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. Intermediate computer and technology skills. Ability to promote teamwork and to effectively function in teams. Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. PHYSICAL ACTIVITIES AND REQUIREMENTS: See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements Job Shift: Day/Evening Schedule: Full Time Shift Hours: 8 Days of the Week: Variable Weekend Requirements: Every other Weekend Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $86.68 to $114.41 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.$86.7-114.4 hourly 60d+ agoCase Manager II, Registered Nurse
Sutter Health
Burlingame, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** Bay Administration Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating in a timely and integrated fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. When assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions. **Job Description** : **EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN-Registered Nurse of California Upon Hire CCM certification preferred **TYPICAL EXPERIENCE:** 5 years recent relevant experience. **SKILLS AND KNOWLEDGE:** A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of care, and observation status. Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, value-based reimbursement models, and alternative payment systems preferred. Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, CDPH and TJC. A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements. General understanding of coding and DRG assignment process preferred. Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. Demonstrates commitment to service excellence in all patients, family and employee interactions and in performing all job responsibilities. Functions in a manner to promote quality patient care and assure a positive patient experience. Strong verbal and written communication skills and negotiation skills Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. Intermediate computer and technology skills. Ability to promote teamwork and to effectively function in teams. Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. **PHYSICAL ACTIVITIES AND REQUIREMENTS:** See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements (*********************************************************************** VGh0qew2nHBZsBpR4VIJFStf2B53bAii2JrA?e=M78vhR) **Job Shift:** Day/Evening **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Variable **Weekend Requirements:** Every other Weekend **Benefits:** Yes **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $86.68 to $114.41 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._ _ _$86.7-114.4 hourly 60d+ agoCase Manager, Registered Nurse
Sutter Health
San Francisco, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SHSO-Population Health Services-Bay Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating in a timely and integrated fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. If assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions. **Job Description** : **EDUCATION:** + Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + 2 years recent relevant experience. **SKILLS AND KNOWLEDGE:** + A broad knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of Utilization Review, levels of care, and observation status. + Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, value-based reimbursement models, and alternative payment systems preferred. + Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, CDPH and TJC. + A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements. + General understanding of coding and DRG assignment process preferred. + Must be able to effectively communicate with and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. + Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. + Demonstrates commitment to service excellence in all patients, family and employee interactions and in performing all job responsibilities. + Functions in a manner to promote quality patient care and assure a positive patient experience. + Strong verbal and written communication skills and negotiation skills + Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. + Intermediate computer and technology skills. + Ability to promote teamwork and to effectively function in teams. + Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. **PHYSICAL ACTIVITIES AND REQUIREMENTS:** See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements (*********************************************************************** VGh0qew2nHBZsBpR4VIJFStf2B53bAii2JrA?e=M78vhR) **Job Shift:** Varied **Schedule:** Per Diem/Casual **Shift Hours:** 8 **Days of the Week:** Variable **Weekend Requirements:** One Weekend Shift a month **Benefits:** No **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 0 **Employee Status:** Per Diem/Casual Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $90.75 to $118.88 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._ _ _$90.8-118.9 hourly 32d agoCase Manager, Registered Nurse
Sutterhealth
San Francisco, CA jobs
We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Bay Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating in a timely and integrated fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. If assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions. Job Description: EDUCATION: Graduate of an accredited school of nursing CERTIFICATION & LICENSURE: RN-Registered Nurse of California Upon Hire TYPICAL EXPERIENCE: 2 years recent relevant experience. SKILLS AND KNOWLEDGE: A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of care, and observation status. Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, value-based reimbursement models, and alternative payment systems preferred. Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, CDPH and TJC. A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements. General understanding of coding and DRG assignment process preferred. Must be able to effectively communicate with and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. Demonstrates commitment to service excellence in all patients, family and employee interactions and in performing all job responsibilities. Functions in a manner to promote quality patient care and assure a positive patient experience. Strong verbal and written communication skills and negotiation skills Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. Intermediate computer and technology skills. Ability to promote teamwork and to effectively function in teams. Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. PHYSICAL ACTIVITIES AND REQUIREMENTS: See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements Job Shift: Varied Schedule: Per Diem/Casual Shift Hours: 8 Days of the Week: Variable Weekend Requirements: One Weekend Shift a month Benefits: No Unions: No Position Status: Non-Exempt Weekly Hours: 0 Employee Status: Per Diem/Casual Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $90.75 to $118.88 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.$90.8-118.9 hourly Auto-Apply 33d agoCase Manager II, Registered Nurse
Sutter Health
San Francisco, CA jobs
We are so glad you are interested in joining Sutter Health! Organization: CPMC-California Pacific Med Center Davies Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted criteria for ambulatory, acute, and post-acute patients to confirm medical necessity is met and at the appropriate level of care. Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation. Strives to promote patient wellness, improved care outcomes, and efficient utilization of health services among a patient population with complex health needs. Job Description: EDUCATION: * Associate Degree in Nursing * Other: Graduate of an accredited school of nursing CERTIFICATION & LICENSURE: * RN-Registered Nurse of California * CCM - Certified Case Manager (certification may be required by entity and time to acquire within 2 years of hire) TYPICAL EXPERIENCE: * 2 years recent relevant experience SKILLS AND KNOWLEDGE: * A broad knowledge base of health care delivery and case management within a managed care environment. * Comprehensive knowledge of Utilization Review, levels of care, and observation status. * Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care, National Committee for Quality Assurance (NCQA). * A broad knowledge base of outpatient, acute, and post-acute levels of care and associated regulatory compliance requirements. * Must be able to effectively communicate with and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. * Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. * Demonstrates commitment to service excellence in all patients, family, and employee interactions and in performing all job responsibilities. * Functions in a manner to promote quality patient care and assure a positive patient experience. * Verbal and written communication skills. * Interpersonal communication and negotiation skills. * Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. * Intermediate computer skills. * Ability to promote teamwork and to effectively function in teams. * Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. PHYSICAL ACTIVITIES AND REQUIREMENTS: See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements Job Shift: Days Schedule: Per Diem/Casual Shift Hours: 8 Days of the Week: Monday - Friday Weekend Requirements: None Benefits: No Unions: No Position Status: Non-Exempt Weekly Hours: 0 Employee Status: Per Diem/Casual Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $86.68 to $114.41 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.$86.7-114.4 hourly 9d agoCase Manager II, Registered Nurse
Sutter Health
San Francisco, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** CPMC-California Pacific Med Center Davies Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted criteria for ambulatory, acute, and post-acute patients to confirm medical necessity is met and at the appropriate level of care. Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation. Strives to promote patient wellness, improved care outcomes, and efficient utilization of health services among a patient population with complex health needs. **Job Description** : **EDUCATION:** + Associate Degree in Nursing + Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + CCM - Certified Case Manager (certification may be required by entity and time to acquire within 2 years of hire) **TYPICAL EXPERIENCE:** + 2 years recent relevant experience **SKILLS AND KNOWLEDGE:** + A broad knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of Utilization Review, levels of care, and observation status. + Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care, National Committee for Quality Assurance (NCQA). + A broad knowledge base of outpatient, acute, and post-acute levels of care and associated regulatory compliance requirements. + Must be able to effectively communicate with and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. + Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. + Demonstrates commitment to service excellence in all patients, family, and employee interactions and in performing all job responsibilities. + Functions in a manner to promote quality patient care and assure a positive patient experience. + Verbal and written communication skills. + Interpersonal communication and negotiation skills. + Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. + Intermediate computer skills. + Ability to promote teamwork and to effectively function in teams. + Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. **PHYSICAL ACTIVITIES AND REQUIREMENTS:** See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements (*********************************************************************** VGh0qew2nHBZsBpR4VIJFStf2B53bAii2JrA?e=M78vhR) **Job Shift:** Days **Schedule:** Per Diem/Casual **Shift Hours:** 8 **Days of the Week:** Monday - Friday **Weekend Requirements:** None **Benefits:** No **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 0 **Employee Status:** Per Diem/Casual Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $86.68 to $114.41 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._ _ _$86.7-114.4 hourly 10d agoCase Manager II, Registered Nurse
Sutterhealth
San Francisco, CA jobs
We are so glad you are interested in joining Sutter Health! Organization: CPMC-California Pacific Med Center Davies Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted criteria for ambulatory, acute, and post-acute patients to confirm medical necessity is met and at the appropriate level of care. Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation. Strives to promote patient wellness, improved care outcomes, and efficient utilization of health services among a patient population with complex health needs. Job Description: EDUCATION: Associate Degree in Nursing Other: Graduate of an accredited school of nursing CERTIFICATION & LICENSURE: RN-Registered Nurse of California CCM - Certified Case Manager (certification may be required by entity and time to acquire within 2 years of hire) TYPICAL EXPERIENCE: 2 years recent relevant experience SKILLS AND KNOWLEDGE: A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of care, and observation status. Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care, National Committee for Quality Assurance (NCQA). A broad knowledge base of outpatient, acute, and post-acute levels of care and associated regulatory compliance requirements. Must be able to effectively communicate with and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners. Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families. Demonstrates commitment to service excellence in all patients, family, and employee interactions and in performing all job responsibilities. Functions in a manner to promote quality patient care and assure a positive patient experience. Verbal and written communication skills. Interpersonal communication and negotiation skills. Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities. Intermediate computer skills. Ability to promote teamwork and to effectively function in teams. Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience. PHYSICAL ACTIVITIES AND REQUIREMENTS: See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements Job Shift: Days Schedule: Per Diem/Casual Shift Hours: 8 Days of the Week: Monday - Friday Weekend Requirements: None Benefits: No Unions: No Position Status: Non-Exempt Weekly Hours: 0 Employee Status: Per Diem/Casual Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $86.68 to $114.41 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.$86.7-114.4 hourly Auto-Apply 11d agoRN Case Manager, Home Health
Sutter Health
Alameda, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SCAH-Sutter Care at Home - Bay Successful candidate will have experience in an Home Health environment. The Primary Care Clinician reports directly to the Clinical Manager as do the other members of the interdisciplinary team. The Primary Care Clinician may give functional guidance to Team RNs, LVNs, PTAs, OTs, COTAs, SLPs, MSWs, RDs and HHAs. **Job Description** : **EDUCATION** + _Equivalent experience will be accepted in lieu of the required degree or diploma._ + Other: RN graduate from an accredited curriculum. + Bachelor's: Nursing or health related field preferred **CERTIFICATION & LICENSURE** + RN-Registered Nurse of California + DL-Valid Drivers License Class C or B + AUTO-Automobile Insurance + BLS-Basic Life Support Healthcare Provider **PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:** + 1 One year of professional experience in an acute or similar setting required. + 1 One year of experience in a home health and/or hospice position preferred. + 5 Direct patient care experience within the past five years required. **SKILLS AND KNOWLEDGE** + Thorough understanding of home care and/or hospice services, Title XXII, Medicare Conditions of Participation, CHAP home health and/or hospice accreditation requirements, QI outcomes/benchmarking, infection control; good understanding of reimbursement patterns for Medicare and other payors; good working understanding of budget and other financial reports. + Clinical competency that meets and exceeds testing levels on a regular basis. + Self-starter with a high degree of initiative, motivation, flexibility, energy and creativity. + Ability to form harmonious working relationships with internal and external customers. + Demonstrated leadership and negotiation skills and the ability to manage resources for patient care in a cost effective manner. + Excellent collaborative and problem solving skills with customers and management. + Ability to exercise independent sound judgment in planning and providing patient care. + Demonstrated ability in physical, psychosocial, and environmental assessment skills and in implementing plan of treatment. + Excellent organizational skills. + With appropriate training, demonstrates an ability to competently work with the computerized documentation tools and systems of the organization. + Access to a reliable automobile. + Must be able to meet company productivity standards as indicated by organization and manager. + Must be able to handle sensitive issues, conflict with or among others, respectively direct and reinforce staff efforts; effectively plan and organize and prioritize work, think critically to both effectively plan and organize department operations consistent with Sutter Care at Home's strategic and operating objectives and to effectively solve unique problems as they arise or identify when to consult supervisor. + Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. + Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. + Is responsible for maintaining all required licensure and certifications. + At orientation and annually thereafter, must be able to meet Sutter VNA & Hospice core competencies for position and area of specialty, as appropriate. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday, Variable **Weekend Requirements:** Rotating Weekends **Benefits:** Yes **Unions:** Yes **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $70.98 to $95.38 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._$71-95.4 hourly 10d agoRN Case Manager, Hospice
Sutter Health
Alameda, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SCAH-Sutter Care at Home - Bay Experienced Registered Nurse who provides skilled palliative and end of life care in the community setting in alignment with Sutter's mission, goals and objectives. Facilitates the development of a collaborative interdisciplinary plan and ensures the overall coordination and medical management of hospice services for patients and their significant others. **Job Description** : **EDUCATION:** + Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + BLS-Basic Life Support Healthcare Provider + DL-Valid Drivers License + AUTO-Automobile Insurance **TYPICAL EXPERIENCE:** + 2 years recent relevant experience. **SKILLS AND KNOWLEDGE:** + Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. + Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. + Knowledge of basic safety and infection control principles. + Knowledge of state and federal home care regulatory guidelines preferred. + Demonstrated clinical assessment skills. + Ability to recognize the special needs of Hospice patients and others in the home. + Ability to communicate with patients and significant others in an effective, mature, caring manner. + Ability to maintain harmonious constructive relationships with internal and external customers. + Demonstrated effective written and verbal communication skills. + Understanding of palliative care for the terminally ill patient. + Must be able to recognize unsafe or emergency situations and act appropriately. + Must be able to meet company productivity standards as indicated by organization and manager. + Must be able to handle sensitive issues, conflict with or among others, respectively direct and reinforce staff efforts; effectively plan and organize and prioritize work, think critically to both effectively plan and organize department operations and to effectively solve unique problems as they arise or identify when to consult supervisor. + Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. + Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. + Is responsible for maintaining all required licensure and certifications. + Must have reliable transportation. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday, Variable **Weekend Requirements:** Rotating Weekends **Benefits:** Yes **Unions:** Yes **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $70.98 to $95.38 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._$71-95.4 hourly 34d agoRN Case Manager, Hospice
Sutterhealth
Alameda, CA jobs
We are so glad you are interested in joining Sutter Health! Organization: SCAH-Sutter Care at Home - Bay Experienced Registered Nurse who provides skilled palliative and end of life care in the community setting in alignment with Sutter's mission, goals and objectives. Facilitates the development of a collaborative interdisciplinary plan and ensures the overall coordination and medical management of hospice services for patients and their significant others. Job Description: EDUCATION: Other: Graduate of an accredited School of Nursing CERTIFICATION & LICENSURE: RN-Registered Nurse of California BLS-Basic Life Support Healthcare Provider DL-Valid Drivers License AUTO-Automobile Insurance TYPICAL EXPERIENCE: 2 years recent relevant experience. SKILLS AND KNOWLEDGE: Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. Knowledge of basic safety and infection control principles. Knowledge of state and federal home care regulatory guidelines preferred. Demonstrated clinical assessment skills. Ability to recognize the special needs of Hospice patients and others in the home. Ability to communicate with patients and significant others in an effective, mature, caring manner. Ability to maintain harmonious constructive relationships with internal and external customers. Demonstrated effective written and verbal communication skills. Understanding of palliative care for the terminally ill patient. Must be able to recognize unsafe or emergency situations and act appropriately. Must be able to meet company productivity standards as indicated by organization and manager. Must be able to handle sensitive issues, conflict with or among others, respectively direct and reinforce staff efforts; effectively plan and organize and prioritize work, think critically to both effectively plan and organize department operations and to effectively solve unique problems as they arise or identify when to consult supervisor. Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. Is responsible for maintaining all required licensure and certifications. Must have reliable transportation. Job Shift: Days Schedule: Full Time Shift Hours: 8 Days of the Week: Monday - Friday, Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: Yes Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $70.98 to $95.38 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.$71-95.4 hourly Auto-Apply 35d agoRN Case Manager, Home Health
Sutterhealth
Alameda, CA jobs
We are so glad you are interested in joining Sutter Health! Organization: SCAH-Sutter Care at Home - Bay Successful candidate will have experience in an Home Health environment. The Primary Care Clinician reports directly to the Clinical Manager as do the other members of the interdisciplinary team. The Primary Care Clinician may give functional guidance to Team RNs, LVNs, PTAs, OTs, COTAs, SLPs, MSWs, RDs and HHAs. Job Description: EDUCATION Equivalent experience will be accepted in lieu of the required degree or diploma. Other: RN graduate from an accredited curriculum. Bachelor's: Nursing or health related field preferred CERTIFICATION & LICENSURE RN-Registered Nurse of California DL-Valid Drivers License Class C or B AUTO-Automobile Insurance BLS-Basic Life Support Healthcare Provider PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN: 1 One year of professional experience in an acute or similar setting required. 1 One year of experience in a home health and/or hospice position preferred. 5 Direct patient care experience within the past five years required. SKILLS AND KNOWLEDGE Thorough understanding of home care and/or hospice services, Title XXII, Medicare Conditions of Participation, CHAP home health and/or hospice accreditation requirements, QI outcomes/benchmarking, infection control; good understanding of reimbursement patterns for Medicare and other payors; good working understanding of budget and other financial reports. Clinical competency that meets and exceeds testing levels on a regular basis. Self-starter with a high degree of initiative, motivation, flexibility, energy and creativity. Ability to form harmonious working relationships with internal and external customers. Demonstrated leadership and negotiation skills and the ability to manage resources for patient care in a cost effective manner. Excellent collaborative and problem solving skills with customers and management. Ability to exercise independent sound judgment in planning and providing patient care. Demonstrated ability in physical, psychosocial, and environmental assessment skills and in implementing plan of treatment. Excellent organizational skills. With appropriate training, demonstrates an ability to competently work with the computerized documentation tools and systems of the organization. Access to a reliable automobile. Must be able to meet company productivity standards as indicated by organization and manager. Must be able to handle sensitive issues, conflict with or among others, respectively direct and reinforce staff efforts; effectively plan and organize and prioritize work, think critically to both effectively plan and organize department operations consistent with Sutter Care at Home's strategic and operating objectives and to effectively solve unique problems as they arise or identify when to consult supervisor. Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. Is responsible for maintaining all required licensure and certifications. At orientation and annually thereafter, must be able to meet Sutter VNA & Hospice core competencies for position and area of specialty, as appropriate. Job Shift: Days Schedule: Full Time Shift Hours: 8 Days of the Week: Monday - Friday, Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: Yes Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $70.98 to $95.38 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.$71-95.4 hourly Auto-Apply 12d agoRN Case Manager, Home Health
Sutter Health
Roseville, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SCAH-Sutter Care at Home - Valley An experienced RN who is responsible for the overall management of patients, including the provision of direct care with a designated visit productivity standard. This position plans, organizes, and directs all patient care services for patients in the assigned caseload in accordance with current standards and regulations, ensuring the optimal degree of quality care is maintained. Responsible for coordinating the interdisciplinary team to implement the established plan of patient care and ensuring effective management of visit utilization and control of expenses. May assist in agency wide orientation, competency evaluations and consultation to clinical staff related to specific expertise. **Job Description** : **FULL-TIME DAY SHIFTS:** Monday-Friday / Rotating Weekends **EDUCATION:** + Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + BLS-Basic Life Support Healthcare Provider + DL-Valid Drivers License Class C or B + AUTO-Automobile Insurance **TYPICAL EXPERIENCE:** + 2 years recent relevant experience **SKILLS AND KNOWLEDGE:** + Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. + Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. + Knowledge of basic safety and infection control principles. + Demonstrated clinical assessment skills. + Ability to recognize the special needs of Hospice patients and others in the home. + Ability to communicate with patients and significant others in an effective, mature, caring manner. + Ability to maintain harmonious constructive relationships with internal and external customers. + Demonstrated effective written and verbal communication skills. + Understanding of palliative care for the terminally ill patient. + Must be able to recognize unsafe or emergency situations and act appropriately. + Must be able to meet company productivity standards as indicated by organization and manager. + Objectively and effectively solves unique problems as they arise or identify when to consult supervisor. + Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. + Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. + Is responsible for maintaining all required licensure and certifications. + Must have reliable transportation. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday **Weekend Requirements:** Rotating Weekends **Benefits:** Yes **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $68.09 to $90.56 / hour _The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package._$68.1-90.6 hourly 3d agoRN Case Manager, Home Health
Sutter Health
San Mateo, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SCAH-Sutter Care at Home - Bay An experienced RN who is responsible for the overall management of patients, including the provision of direct care with a designated visit productivity standard. This position plans, organizes, and directs all patient care services for patients in the assigned caseload in accordance with current standards and regulations, ensuring the optimal degree of quality care is maintained. Responsible for coordinating the interdisciplinary team to implement the established plan of patient care and ensuring effective management of visit utilization and control of expenses. May assist in agency wide orientation, competency evaluations and consultation to clinical staff related to specific expertise. **Job Description** : **EDUCATION:** + Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + BLS-Basic Life Support Healthcare Provider + DL-Valid Drivers License Class C, B, or D + AUTO-Automobile Insurance **TYPICAL EXPERIENCE:** + 2 years recent relevant experience **SKILLS AND KNOWLEDGE:** + Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. + Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. + Knowledge of basic safety and infection control principles. + Demonstrated clinical assessment skills. + Ability to recognize the special needs of Hospice patients and others in the home. + Ability to communicate with patients and significant others in an effective, mature, caring manner. + Ability to maintain harmonious constructive relationships with internal and external customers. + Demonstrated effective written and verbal communication skills. + Understanding of palliative care for the terminally ill patient. + Must be able to recognize unsafe or emergency situations and act appropriately. + Must be able to meet company productivity standards as indicated by organization and manager. + Objectively and effectively solves unique problems as they arise or identify when to consult supervisor. + Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. + Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. + Is responsible for maintaining all required licensure and certifications. + Must have reliable transportation. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday, Variable **Weekend Requirements:** Rotating Weekends **Benefits:** Yes **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $74.90 to $99.62 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._$74.9-99.6 hourly 34d agoRN, Case Manager, Home Health
Sutter Health
Santa Rosa, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SCAH-Sutter Care at Home - Outer Bay An experienced RN who is responsible for the overall management of patients, including the provision of direct care with a designated visit productivity standard. This position plans, organizes, and directs all patient care services for patients in the assigned caseload in accordance with current standards and regulations, ensuring the optimal degree of quality care is maintained. Responsible for coordinating the interdisciplinary team to implement the established plan of patient care and ensuring effective management of visit utilization and control of expenses. May assist in agency wide orientation, competency evaluations and consultation to clinical staff related to specific expertise. **Job Description** : **EDUCATION:** Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** RN-Registered Nurse of California BLS-Basic Life Support Healthcare Provider DL-Valid Drivers License Class C, B, or D AUTO-Automobile Insurance **TYPICAL EXPERIENCE:** 2 years recent relevant experience **SKILLS AND KNOWLEDGE:** Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. Knowledge of basic safety and infection control principles. Demonstrated clinical assessment skills. Ability to recognize the special needs of Hospice patients and others in the home. Ability to communicate with patients and significant others in an effective, mature, caring manner. Ability to maintain harmonious constructive relationships with internal and external customers. Demonstrated effective written and verbal communication skills. Understanding of palliative care for the terminally ill patient. Must be able to recognize unsafe or emergency situations and act appropriately. Must be able to meet company productivity standards as indicated by organization and manager. Objectively and effectively solves unique problems as they arise or identify when to consult supervisor. Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. Is responsible for maintaining all required licensure and certifications. Must have reliable transportation. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday **Weekend Requirements:** Rotating Weekends **Benefits:** Yes **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $71.50 to $95.09 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._$71.5-95.1 hourly 12d agoRN Case Manager, Hospice
Sutter Health
San Mateo, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SCAH-Sutter Care at Home - Bay The Case Manager is an experienced Registered Nurse who provides skilled palliative and end of life care in the community setting in alignment with SCAH, mission, goals and objectives. The Case Manager facilitates the development of a collaborative interdisciplinary plan and ensures the overall coordination and medical management of hospice services for patients and their significant others. **Job Description** : **EDUCATION:** + Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + BLS-Basic Life Support Healthcare Provider + DL-Valid Drivers License + AUTO-Automobile Insurance **TYPICAL EXPERIENCE:** + 2 years recent relevant experience. **SKILLS AND KNOWLEDGE:** + Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. + Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. + Knowledge of basic safety and infection control principles. + Knowledge of state and federal home care regulatory guidelines preferred. + Demonstrated clinical assessment skills. + Ability to recognize the special needs of Hospice patients and others in the home. + Ability to communicate with patients and significant others in an effective, mature, caring manner. + Ability to maintain harmonious constructive relationships with internal and external customers. + Demonstrated effective written and verbal communication skills. + Understanding of palliative care for the terminally ill patient. + Must be able to recognize unsafe or emergency situations and act appropriately. + Must be able to meet company productivity standards as indicated by organization and manager. + Must be able to handle sensitive issues, conflict with or among others, respectively direct and reinforce staff efforts; effectively plan and organize and prioritize work, think critically to both effectively plan and organize department operations and to effectively solve unique problems as they arise or identify when to consult supervisor. + Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. + Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. + Is responsible for maintaining all required licensure and certifications. + Must have reliable transportation. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday, Variable **Weekend Requirements:** Rotating Weekends **Benefits:** Yes **Unions:** Yes **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $70.98 to $95.38 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._$71-95.4 hourly 49d agoRN Case Manager, Home Health
Sutter Health
San Francisco, CA jobs
We are so glad you are interested in joining Sutter Health! **Organization:** SCAH-Sutter Care at Home - Bay Under the supervision of the Clinical Manager, the Primary Care Clinician (PCC) is an experienced RN who is responsible for the overall management of approximately 25 patients including the provision of direct care with a designated visit productivity standard. This position plans, organizes, and directs all patient care services for patients in the assigned caseload in accordance with current standards and regulations, ensuring the optimal degree of quality care is maintained. Responsible for coordinating the interdisciplinary team to implement the established plan of patient care and ensuring effective management of visit utilization and control of expenses. May assist in agency wide orientation, competency evaluations and consultation to clinical staff related to specific expertise as requested by Clinical Manager. The Primary Care Clinician reports directly to the Clinical Manager as do the other members of the interdisciplinary team. The Primary Care Clinician may give functional guidance to Team RNs, LVNs, PTs, OTs, SLPs, MSWs, RDs and HHAs. **Job Description** : **EDUCATION:** + Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + BLS-Basic Life Support Healthcare Provider + DL-Valid Drivers License Class C or B + AUTO-Automobile Insurance **TYPICAL EXPERIENCE:** + 2 years recent relevant experience **SKILLS AND KNOWLEDGE:** + Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. + Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. + Knowledge of basic safety and infection control principles. + Demonstrated clinical assessment skills. + Ability to recognize the special needs of Hospice patients and others in the home. + Ability to communicate with patients and significant others in an effective, mature, caring manner. + Ability to maintain harmonious constructive relationships with internal and external customers. + Demonstrated effective written and verbal communication skills. + Understanding of palliative care for the terminally ill patient. + Must be able to recognize unsafe or emergency situations and act appropriately. + Must be able to meet company productivity standards as indicated by organization and manager. + Objectively and effectively solves unique problems as they arise or identify when to consult supervisor. + Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. + Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. + Is responsible for maintaining all required licensure and certifications. + Must have reliable transportation. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday, Variable **Weekend Requirements:** Rotating Weekends **Benefits:** Yes **Unions:** Yes **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $70.98 to $95.38 / hour _The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._$71-95.4 hourly 60d+ agoRN Case Manager, Home Health
Sutterhealth
San Francisco, CA jobs
We are so glad you are interested in joining Sutter Health! Organization: SCAH-Sutter Care at Home - Bay Under the supervision of the Clinical Manager, the Primary Care Clinician (PCC) is an experienced RN who is responsible for the overall management of approximately 25 patients including the provision of direct care with a designated visit productivity standard. This position plans, organizes, and directs all patient care services for patients in the assigned caseload in accordance with current standards and regulations, ensuring the optimal degree of quality care is maintained. Responsible for coordinating the interdisciplinary team to implement the established plan of patient care and ensuring effective management of visit utilization and control of expenses. May assist in agency wide orientation, competency evaluations and consultation to clinical staff related to specific expertise as requested by Clinical Manager. The Primary Care Clinician reports directly to the Clinical Manager as do the other members of the interdisciplinary team. The Primary Care Clinician may give functional guidance to Team RNs, LVNs, PTs, OTs, SLPs, MSWs, RDs and HHAs. Job Description: EDUCATION: Other: Graduate of an accredited School of Nursing CERTIFICATION & LICENSURE: RN-Registered Nurse of California BLS-Basic Life Support Healthcare Provider DL-Valid Drivers License Class C or B AUTO-Automobile Insurance TYPICAL EXPERIENCE: 2 years recent relevant experience SKILLS AND KNOWLEDGE: Must have the ability to function independently and as a member of an interdisciplinary team; ability to exercise independent, sound nursing judgment in planning and providing patient care. Exhibits knowledge of patho-physiology and accepted treatment protocols for common home care diagnoses. Knowledge of basic safety and infection control principles. Demonstrated clinical assessment skills. Ability to recognize the special needs of Hospice patients and others in the home. Ability to communicate with patients and significant others in an effective, mature, caring manner. Ability to maintain harmonious constructive relationships with internal and external customers. Demonstrated effective written and verbal communication skills. Understanding of palliative care for the terminally ill patient. Must be able to recognize unsafe or emergency situations and act appropriately. Must be able to meet company productivity standards as indicated by organization and manager. Objectively and effectively solves unique problems as they arise or identify when to consult supervisor. Must be able to deal with challenging work environment with time demands and occasional conflicting priorities. Maintain a positive and professional image and demonstrate self-directed learning to meet professional development and/or license requirements. Is responsible for maintaining all required licensure and certifications. Must have reliable transportation. Job Shift: Days Schedule: Full Time Shift Hours: 8 Days of the Week: Monday - Friday, Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: Yes Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines. Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $70.98 to $95.38 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.$71-95.4 hourly Auto-Apply 60d+ agoRN - Case Manager
Sutter Health Alta Bates Summit Medical Center Hawthorne
Oakland, CA jobs
At MedUS Healthcare, our vision is to become a necessary and exemplary partner in the care of our clients, while meeting the employment goals of our healthcare providers and their families. We believe that quality of care and quick delivery to our clients is not optional but, rather, a standard of practice. We are committed to providing quality care to our clients by recruiting the best healthcare providers in the industry as we, concurrently, fulfill our commitment to our healthcare providers by placing them in the best facilities nationwide! If you are interested in a travel position, please contact us today at ************ or send us an email at info@medusinc. com. www. medusinc. com$114k-135k yearly est. 60d+ agoRN, Case Manager III
Memorialcare
Registered nurse case manager job at MemorialCare
Experience Must have experience in Acute Inpatient Rehabilitation Case Management This position requires strong verbal and written communication skills with the ability to communicate well with people from diverse socioeconomic backgrounds. The case manager is knowledgeable of criteria for medical necessity for each level of care through the continuum of care. A knowledge of reimbursement related to MediCare, MediCal, Capitation, and Managed Care is required. Three to five years acute care or home health experience plus prior experience in Quality Improvement, Case Management, Discharge Planning or Utilization Management required. Education Current California RN License. BSN or Bachelors degree in health or related field preferred Title RN Case Manager III Location Long Beach Department Acute Inpatient Rehabilitation Status Full time Shift Day Pay Range $59.87/hr - $83.39/hr $20,000 signing bonus available to external hires new to MHS employment, contingent upon satisfaction of employment requirements. At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary The Case Manager III is a licensed professional who plans, coordinates and facilitates the ongoing care and appropriate discharge plan of a specific caseload of patients through the continuum of care. The case manager III collaborates with members of the health care team, the patient, and their family to assure effective, efficient, and appropriate care and outcomes. The incumbent is accountable for education, monitoring, utilization and evaluation of medical outcomes. Essential Job Outcomes & Functions Care Management Case Management The case manager III independently manages a specific case load of patients as identified by the Resource Management Department and CareLines. The case manager analyzes patient information and assess each patient's functional status and decision making ability in relation to the continuum of care and discharge needs. The case manager collaborates with the health care team, patient, and family in planning and facilitating the achievement of expected outcomes for patients. Each treatment plan is evaluated for appropriate quality outcomes and utilization of resources. Continuum of Care/Quality The case manager III works collaboratively with the health care team to provide education, resources, and referrals as needed for each patient and their family or caretaker. The case manager facilitates coordination among health care professionals, services, and settings involved in the patient's care, with a focus on enhancing patient satisfaction. The case manager actively communicates with nursing leadership, CareLine physician directors, and Medical Directors on quality issues. As appropriate, concerns are referred to various Medical Staff Committees and CareLines through required documentation, including but not limited to the Clinical Pertinence Review Form. The case manager has the responsibility to maintain professionalism and provide ongoing education to the health care team regarding the case manager's role. Utilization Management The case manager works collaboratively and proactively with payors in managing patient resources. The case manager assures the hospital receives appropriate reimbursement through collaboration with the health care team and provides timely clinical review, as well as retroactive review for unbilled accounts. The case manager utilizes the billing system to analyze charges vs. reimbursement and contract information. This information is used to structure the health care team toward effective utilization of resources. The case manager incorporates knowledge of medical necessity, CareLine protocols, and MAPs to evaluate for appropriateness of admissions, continued stay, and discharges. The case manager refers cases, as appropriate, for review to the Combined Resource Management Committee and other Medical Staff Committees as needed. Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare-that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there's more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.$59.9-83.4 hourly Auto-Apply 45d ago
Learn more about MemorialCare jobs
- Reviews
