Job Description

Job Title: Manager Case Management

Location: Riverside, CA

Shift: Admin Hours - Rotating Weekends

Duration: Full time/permanent

Relocation: Case by Case

Job Summary and Qualifications:

The Manager of Case Management is a Registered Nurse with advanced training and experience in Case Management. This position reports to the Director of Case Management & Social Services. The Manager is responsible and accountable for monitoring the case management department’s processes throughout the hospital utilizing the established tools, policies and procedures, and professional standards. The Manager will ensure the services provided are appropriate for the patient/family needs, meet regulatory compliance requirements and are congruent with the hospital’s mission and vision. Defining characteristics of the position include: leadership, collaboration, consultation, education, and professional development.

• You will assist with patient throughput, including but not limited to: assisting with evaluation of direct admits and monitoring and assisting with timely discharge planning.
• You will develop, achieve and sustain positive relationships with all continuum of care providers including but not limited to: physicians; health plans; payers; patients / families; the healthcare team and all other customers.
• You will promote timely and safe discharge plans to promote an optimal and appropriate length of stay.
• You will manage the day-to-day running of the department including but not limited to staffing, attendance, schedule, balancing case load, and daily rounding on floors to interact with and support case management staff.

What qualifications you will need:

• Bachelors Degree in Nursing (BSN) required. Masters Degree (MSN) preferred.
• Current California Licensed Registered Nurse
• Minimum of 5 years case management in an acute hospital setting and/or nursing management experience in an acute hospital setting
• Thorough knowledge of Case Management defined by established rules and regulations of federal and non-federal programs.
• Working knowledge of both Interqual and M & R.
• Understanding of hospital reimbursement as it relates to different payers such as Medicare, Medi-cal, Managed Care and private insurance plans.

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