Case Management Nurse; Department Promotional

San Mateo Medical Center – Full-Time Case Management Nurse

San Mateo Medical Center is currently seeking one Full-Time
Case Management Nurse to focus on Utilization Review and Discharge Planning.

At San Mateo Medical Center, we are always seeking ways to enhance the already impressive services we offer. This dedication to excellence is reflected in the exceptional care we provide and the extraordinary professionals who provide it. Here, you will have the chance to develop your talents with a skilled team of people who actively support and encourage each other's success.

If you are ready to open new doors for your career, join us today!

Exciting news! Candidates have the opportunity to receive a sign-on bonus of up to $30,000. First-time external new hires, or current staff promoted internally or from other County departments into a regular Supervising Physician position in San Mateo Medical Center (SMMC) may be eligible to receive a sign-on bonus of up to $30,000 (subject to discontinuation at any time). The sign-on bonus will be in 3 phases and will be prorated for part-time.

The Case Management Nurse will manage patient admission and ongoing stay reviews for patients with chronic or complicated medical conditions; work closely with patients and their loved ones and interdisciplinary team to evaluate patients' needs and come up with a comprehensive discharge plan that speaks to their preferences and goals; oversee appeals with third-party payors; and initiate and coordinate complex discharge plans.

This position will focus on acute inpatient psychiatry, the Medical Surgical Unit and the Intensive Care unit. The incumbent will be responsible for retrospective and concurrent Utilization Review activities, discharge planning, and for monitoring documentation, accuracy, and clinical compliance, in accordance with State and Federal regulations. In conjunction with other members of the health care team, the Case Management Nurse is accountable for timely coordination of quality health care services to meet the patient's health care needs across the continuum of care.

The position requires knowledge of the development stages, as services are provided to infants, children, adolescent, pediatric, adult, and geriatric populations.

• At least two years of recent, direct, and proven experience in Nurse Case Management in an acute care setting or at least two years of acute care hospital nursing experience.
• At least two years of experience with industry published standards of level of care (i.e. Inter Qual or Milliman, etc.).
• A Basic Life Support (BLS) certificate.
• Experience working with diverse, underserved populations.

• Identify problem situations or patient care issues; analyze, interpret, advise and consult with staff and other health care professionals to ensure patient order status reflects the correct level of care.
• Interpret and modify the system of patient care delivered by evaluating and reviewing standard practices and initiating new procedures.
• Provide consultation and guidance to providers to understand and ensure appropriate care is provided based on patient level of care needs.
• Advise the nursing staff in the establishment and maintenance of records of treatments given and the related progress of each patient for the purpose of analyzing patterns, synthesizing actions and evaluating patient care plans.
• Resolve unusual or unique patient care problems or situations, which require analytical, interpretative and constructive thinking.
• Formulate and develop plans, procedures and program content designed to meet specifically identified training/educational needs of nursing staff.
• Conduct formal classroom instruction in the more difficult or complex areas of nursing technology requiring a knowledge and understanding of the scientific principles and theoretical concepts underlying specific nursing procedures or techniques.
• Formulate, and/or collaborate with other health care practitioners to identify relevant clinical problems and conduct research to bring about their resolution.
• Communicate research findings by publication and presentation at professional…