Registered Nurse Case Manager (RN)

OverviewAre you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Desert Regional Medical Center hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.At Desert Regional Medical Center, We Understand That Our Greatest Asset Is Our Dedicated Team Of Professionals. That’s Why We Offer More Than a Job – We Provide a Comprehensive Benefit Package That Prioritizes Your Health, Professional Development, And Work-life Balance. The Available Plans And Programs Include:Medical, dental, vision, and life insurance401(k) retirement savings plan with employer matchGenerous paid time offCareer development and continuing education opportunitiesHealth savings accounts, healthcare & dependent flexible spending accountsEmployee Assistance program, Employee discount programVoluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insuranceNote: Eligibility for benefits may vary by location and is determined by employment statusJob SummaryShift: DaysJob type: Full timeHours: 0800-1630**Up to $25,000.00 Sign on Bonus for Qualified Candidates**GENERAL DUTIES:The individual in this position has overall responsibility for overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements. This position integrates care coordination, utilization management, and discharge planning.The individual’s responsibilities will include, but not be limited to the following activities: a) medical necessity screening b) care coordination c) discharge planning d) facilitating multi-disciplinary patient care conferences e) managing concurrent disputes f) making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST) g ) referring complex social issues to Social Service h ) communicating with patients and their families about the plan of care i) collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy) j) participating in weekly Complex Case Review k) arranging for post –discharge patient education l) clear, complete and concise documentation in eCCM m ) maintaining accuracy of patient demographic and insurance information n) identifying and documenting potentially avoidable days o) identifying and reporting over and under utilization o) and other duties as assigned.Attends hospital workshop led by the Director of Case Management or designee that includes the Tenet Case Management Model, InterQual, Discharge Planning, Utilization Management, and other topics specific to case management. Extended orientation with selected Case Managers may occur.Information used to perform job: patient data, healthcare staff documentation related to patient care, regulatory and payor requirementsSoftware used to perform job: eCCM: Clinical data interface, InterQual, Case Management documentation, secure faxing, Avoidable Day tracking, Patient Medical Record and HPF, Hospital specific Clinical SoftwareResponsibilitiesDEPARTMENT SPECIFIC DUTIES:Priority 1: Coordination of clinical care (medical necessity, appropriateness of care and resource utilization for admission, continued stay, discharge and post- acute care) compared to evidence-based practice, internal and external requirements. (40% daily, essential).Priority 2: Identify and report variances in appropriateness of medical care provided, over/under utilization of resources compared to evidence-based practice and external requirements. This priority includes work with relevant software and communicating information through clear, complete and concise documentation in eCCM (40% daily, essential).Priority 3: Effective collaboration with physicians, nurses, ancillary staff, payors, patients and families to achieve optimum clinical outcomes (10% daily, essential).Priority 4. Remain current with relevant clinical/case management practices. (10% daily, essential).QualificationsRequired:Must have 5 years CM experience in an acute care setting; planning and executing post acute care discharges.Proficient in care coordination in an acute care settingKnowledgeable of available resources for post acute discharge.Demonstrated ability to effectively utilize Allscripts case management software.Strong understanding of medical terminology, procedures, and documentation practices specific to neonatal care.Excellent communication skills, both written and verbal, with the ability to interact effectively with multidisciplinary teams, patients, and families.Proven track record of conducting thorough assessments, developing care plans, safe discharge plans, and ensuring appropriate utilization of resources for neonatal patients.Ability to provide and manage multiple tasks efficiently in a fast-paced environment.Detail-oriented with a commitment to accuracy and compliance with regulatory standards and organizational policies.Experience collaborating with insurance providers and external healthcare agencies to facilitate optimal patient outcomes and resource utilization.Current California RN licensure.Preferred:B.S.N. preferredPHYSICAL REQUIREMENTS:While performing the duties of this job, the employee is regularly required to sit, talk, and hear. The employee is frequently required to use fine motor skill (typing/data entry), and reach with hands and arms. The employee is frequently required to stand; walk; and occasionally stoop, kneel, or crawl. The employee must regularly lift and /or move up to 20 pounds and occasionally lift and/or move up to 50 pounds. Individual works in a clinical and office environment.Organization DescriptionDesert Care Network serves the healthcare needs of the Coachella Valley and Morongo Basin regions in Southern California with three hospitals Desert Regional Medical Center in Palm Springs, JFK Memorial Hospital in Indio and Hi-Desert Medical Center in Joshua Tree. The hospital network provides advanced care with services such as comprehensive stroke care, a cancer center, a Level 1 Trauma Center and the only Level 3 Neonatal Intensive Care Unit (NICU) in the Coachella Valley. Desert Care Network is committed to healthcare equality. Join our team!Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.Tenet participates in the E-Verify program. Follow the link below for additional information.E-Verify: http://www.uscis.gov/e-verifyThe employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.2503034412Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship., $57.54 - $88.43 hourly **Individual wages are determined based upon a number of factors including, but not limited to, an individual’s qualifications and experience,PHYSICAL REQUIREMENTS:While performing the duties of this job, the employee is regularly required to sit, talk, and hear. The employee is frequently required to use fine motor skill (typing/data entry), and reach with hands and arms. The employee is frequently required to stand; walk; and occasionally stoop, kneel, or crawl. The employee must regularly lift and /or move up to 20 pounds and occasionally lift and/or move up to 50 pounds. Individual works in a clinical and office environment.,DEPARTMENT SPECIFIC DUTIES:Priority 1: Coordination of clinical care (medical necessity, appropriateness of care and resource utilization for admission, continued stay, discharge and post- acute care) compared to evidence-based practice, internal and external requirements. (40% daily, essential).Priority 2: Identify and report variances in appropriateness of medical care provided, over/under utilization of resources compared to evidence-based practice and external requirements. This priority includes work with relevant software and communicating information through clear, complete and concise documentation in eCCM (40% daily, essential).Priority 3: Effective collaboration with physicians, nurses, ancillary staff, payors, patients and families to achieve optimum clinical outcomes (10% daily, essential).Priority 4. Remain current with relevant clinical/case management practices. (10% daily, essential).