Lead RN Case Manager - San Gorgonio Memorial Hospital
Banning, CA
About the Job
THIS POSITION IS FOR INTERNAL CANDIDATES ONLY!!
POSITION SUMMARY:
Under the general supervision of the Chief Nursing Officer/VP theLead RN Case Managerwill manage the Case Management Department and clinical resource utilization and documentation effecting reimbursement. In this position the Lead RN Case Manager will provide identification of inefficiencies in resource utilization, and act as a resource to staff and physicians of San Gorgonio Memorial Hospital in documentation for effective reimbursement.
The Lead RN Case Managerassists with controlling staffing levels to meet budgetary guidelines; trains, evaluates, disciplines, and discharges subordinate staff, in collaboration with department director. Communicates with patients, family, medical team, caregivers, and third-party payors as necessary. Formulates, implements, and evaluates educational strategies for staff, patients, and family. Analyzes case management/care coordination outcomes to identify issues and make recommendations. Engages physician advisor to facilitate care decisions, as needed. Maintains current knowledge of health care techniques/practices, and care management strategies through educational programs/resources. Maintains a working knowledge of the requirements of payers, regulatory and compliance entities. Establishes and maintains effective relationships with physicians and all other staff members, internally and externally.
REQUIREMENTS:
Education:
- ADN/BSN in Nursing. BSN preferred. Ongoing education in your field.
Licensure:
- Current CA RN License
Experience:
- 3 year’s minimum clinical Experience.
- Completed at least three years in Case Management position in an acute care setting.
- Previous experience managing a case management program highly desired.
- Knowledge and experience with InterQual (CERME) or other national standard.
- Knowledge and experience with Medi-Cal.
- Excellent communication skills and ability to work with others.
- Familiarity with psychiatric presentations, mental health services including 5150 criteria.
- Knowledge of local community resources and procedures for access.
- Computer data input skills and experience desirable.
- Especially knowledge and skills in Interqual reviews.
BENEFITS
• Benefits may include medical, dental, vision, basic life and AD&D, optional supplemental life (employee, spouse, and/or child coverage), flexible spending accounts (medical and dependent care), 403b retirement with dollar for dollar match up to 5%, paid time off, and more available depending on employment status.
M/F/D/V/SO
EOE