Registered Nurse Case Manager; RN

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Location
:
San Ramon, CA area

The RN Case Manager is responsible for facilitating care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions.

This role integrates national standards for case management scope of services including utilization management, transition management, care coordination, and compliance with regulatory requirements and Tenet policy.

• Facilitate care coordination across the continuum to promote timely throughput and appropriate level of care based on medical necessity.
• Perform accurate medical necessity screening and coordinate physician advisor review as part of the case management process.
• Lead and participate in transition planning, assessment, and reassessment; implement or oversee the transition plan; coordinate multi-disciplinary patient care conferences.
• Communicate with patients, families, physicians, and ancillary staff about the plan of care; collaborate with office staff and other departments as needed.
• Identify and refer complex patients to Social Work Services; manage concurrent disputes; maintain timely documentation in the Case Management system.
• Maintain patient demographic and insurance information accurately; identify and document potentially avoidable days and report utilization variances.
• Provide education to patients, families, and the healthcare team regarding care options, resources, and post-acute needs.
• Ensure compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policies; participate in required training and education.
• May supervise LVN/LPN Case Manager and/or Case Management Assistant/Discharge Planner as assigned.

• Minimum Education
  :
  Graduate of an accredited School of Nursing; BSN preferred.
• Minimum Experience
  :
  At least two (2) years of recent Case Management experience in an acute hospital setting or Master’s Degree in Case Management.
• Demonstrated organizational skills, excellent verbal and written communication, ability to coordinate a diverse team in a fast-paced environment, critical thinking, problem solving, and computer literacy.
• Licenses/Certificates
  :
  Current California Registered Nurse License; ACM or CCM preferred.
• Physical Demands
  :
  Per job requirements.
• Work Environment
  :
  Fast-paced clinical and office environment.
• Training
  :
  Complete Tenet Inter Qual education within 30 days of hire and demonstrate competency in Tenet Case Management documentation; complete Compass Directional Training within 90 days; attend orientation.

• Salary range: $77.88 - $94.77 hourly (individual wages determined by qualifications and experience).
• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine; retirement plans including a 401(k) with employer match; tuition assistance; relocation assistance for select positions.

San Ramon Regional Medical Center began serving residents of the San Ramon Valley and surrounding communities in 1990. It is a 123-bed acute-care hospital, primary stroke center, and cardiac heart surgery hospital offering inpatient and outpatient services with a patient-centered philosophy.

Benefits may vary by location and role.

Employment practices will not be influenced or affected by an applicant’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.