RN Case Manager

Overview

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services.

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• The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace the care for outcomes while meeting core measures within the appropriate level of care.
• The RN Case Manager provides discharge planning by collaboratively determining level of care needs beyond acute care, providing decision support to patients and families and physicians, managing patient and family expectations and ensuring a smooth transition to the next level of care and services.
• The RN Case Manager performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity to achieve reimbursement for services and ensuring appropriate utilization of hospital resources.