CASE MANAGER,CENTRAL PLACE CTR in San Diego, CA at Scripps Corporate Offices

Date Posted: 2/23/2018

Job Snapshot

Job Description

Coordinates direct admissions and transfers into Scripps acute facilities. Ensure delivery of optimal service while promoting fiscal responsibility. Ensure the daily operations, procedures and standards of care are maintained in accordance with hospital and regulatory guidelines. Utilizing critical thinking, interpersonal and technical skills, provides a high level of clinical assessment of patients to ensure placement in the appropriate level of care. Utilizes InterQual criteria to address the issues of medical necessity and appropriate registration of level of care. Evaluates available resources, plans and implements necessary services and monitors outcomes. Requires an understanding of financial reimbursements and third party payments. Acts as a resource to medical, hospital and medical office staff. Participates in data collection as required.

Job Requirements

Required Education/Experience/Specialized Skills: Requires demonstrated excellence in acute clinical nursing plus additional experience in case management/utilization review. Ability to providing direction and work collaboratively with other personnel. Requires superior critical thinking and clinical/fiscal skills; be able to multi-task and perform high level decision making. Have excellent written and verbal skills; must be able to relate positively to the multi-disciplinary healthcare team. Knowledge of various reimbursement methodologies preferred. Possess complex problem solving skills, the ability to manage conflict, and respond to significant amounts of sensory stimuli. Demonstrates the ability to initiate, accept and adapt to change using superior interpersonal skills to achieve desired results. Knowledge of InterQual and Milliman guidelines preferred. Computer literacy in MS Office applications and comfortable with hospital computer applications.

Required Certification/Registration: Current California Registered Nurse License.

Preferred Education/Experience/Specialized Skills/Certification: Bachelor's Degree in Nursing. ACM or CCM or CPUR.

Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, among other things, or status as a qualified individual with disability.