Care Manager Lead; RN : Care Management

Overview

The Care Manager Lead (RN) utilizes clinical expertise, patient assessments, and insurance payer requirements to coordinate patients’ needs through the continuum of care including post-acute care and discharge plans. This role works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care. Resource utilization is considered when coordinating the patients’ needs through the continuum of care.

May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support. May review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans. May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing. May provide psychodynamic intervention and crisis counseling to support patients and families.

May educate patients and families on their healthcare options and connect them with resources. Documents pertinent patient issues, contacts and discharge plans on the medical records. Is a mandated reporter for elder, child, and spousal abuse. Performs other duties as assigned. If in a Magnet facility, participates in Magnet councils and acts as a preceptor in the Nurse Care Manager intern program.

Provides training and clinical supervision to pre-licensed staff as needed. The Lead will provide input to performance evaluations, scheduling, and monitoring workflows. Responsible for fiscal goals, budget, and productivity.

• May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support.
• May review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans.
• May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing.
• May provide psychodynamic intervention and crisis counseling to support patients and families.
• May educate patients and families on their healthcare options and connect them with resources.
• Documents pertinent patient issues, contacts and discharge plans on the medical records.
• Is a mandated reporter for elder, child, and spousal abuse.
• Performs other duties as assigned.
• If in a Magnet facility, participates in Magnet councils and acts as a preceptor in the Nurse Care Manager intern program.
• Provides training and clinical supervision to pre-licensed staff as needed.
• The Lead will provide input to performance evaluations, scheduling, and monitoring workflows.
• Responsible for fiscal goals, budget, and productivity.
• Performs other duties as assigned.

• Bachelor’s or Master’s degree in Nursing (BSN/ MSN) required.
• Five (5) years’ of clinical experience in an acute healthcare system environment required.
• One (1) year supervisory experience, preferably in an acute healthcare system required.
• Strong background in psychosocial assessments and managing chronic and acute disease required.
• Experience with Microsoft office and healthcare database systems required.
• Fulfills mandatory stroke education requirements per certification agency
• Bilingual or multilingual preferred.

• Care Manager Lead (RN)- Registered Nurse (RN) in good standing in the State of California

• Certification in Utilization Review, Care Management, or Clinical Nursing preferred.
• Additional requirements for specific departments are as follows:
  Oncology and Palliative Care:
  Oncology Social Work Certification (OSW-C) preferred.

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is…