RN Case Manager - Care Coordination - Full Time 8 Hours Day (Non-Exempt, Union) *Up to $20000 Sign On Bonus*
Join to apply for the RN Case Manager - Care Coordination - Full Time 8 Hours Day (Non-Exempt, Union) *Up to $20000 Sign On Bonus* role at Keck Medicine of USC
Position Summary
The purpose of the Case Coordinator position is to support the physician and interdisciplinary team in the provision of patient care, with the goal of enhancing clinical outcomes and patient satisfaction while managing care costs. The role involves coordinating utilization management, care facilitation, and discharge planning. The Case Coordinator manages a caseload, plans to meet patient needs, manages length of stay, and promotes resource utilization. Responsibilities include facilitating pre-certification and payer authorization, managing patient care across the continuum, removing barriers to care, applying process improvement methods, coaching clinical documentation, and serving as a resource for coders and physicians.
Essential Job Functions and Core Responsibilities
Participate in clinical performance improvement activities.
Apply InterQual criteria to monitor admission appropriateness and document findings.
Collect and report data on LOS, resource utilization, costs, patient satisfaction, and quality indicators.
Collaborate with the multidisciplinary team on discharge planning, including assessment, planning, and evaluation.
Work with medical and nursing staff to eliminate barriers to care.
Facilitate patient care management, monitor progress, and communicate with payers and the care team.
Coordinate with external case managers and document relevant information in the system.
Manage utilization review and discharge planning for assigned patients.
Ensure communication of care plans to patients, families, and team members, and document accordingly.
Facilitate transfers, identify at-risk populations, and initiate referrals for home health or hospice as needed.
Manage discharge processes, monitor LOS, and address obstacles to discharge.
Perform UR review for Medicare admissions and resolve delays or issues.
Use data and quality screens to drive improvements and resolve conflicts as necessary.
Maintain active communication with physicians and the care team to ensure timely management.
Minimum Education and Licensure
Bachelor’s degree in nursing.
Current RN license in California.
Maintain BLS certification.
Preferred Qualifications
Professional certification as a case manager is preferred.