Registered Nurse, Care Manager (Per Diem)

Work Location: Orange, California
Work Shift: Day – 08hrs

About the role

At CHOC, we strive to be the leading destination of children’s health by providing exceptional and innovative care. We are responsible for the overall health of our community’s pediatric population in our hospitals, clinics, and practices. The RN Care Manager is responsible for one of the following: utilization review of all inpatient services; the delivery of care coordination services for patients admitted to an inpatient bed or in the specialty clinics. Assumes a leadership role for the primary role assigned to the interdisciplinary team to achieve optimal clinical and resource outcomes.

Provides oversight for care teams which includes the care manager assistant and other members responsible for assisting patients and families with navigating the pediatric system of care. Is involved in the planning and delivery of patient and family-centered care through a collaborative process including the patient and family, nurses, social workers, physicians, other practitioners, caregivers, and the community. Also responsible for securing authorizations and promoting the efficient use of healthcare resources. Provides a full range of nursing care and assists in meeting the comprehensive care needs of the patients and their families.

Responsibilities

• Perform utilization review of all inpatient services or deliver care coordination services for patients admitted to an inpatient bed or in specialty clinics.
• Assume a leadership role within the interdisciplinary team to achieve optimal clinical and resource outcomes.
• Provide oversight for care teams, including care manager assistants and other members assisting patients and families with navigating the pediatric system of care.
• Plan and deliver patient and family-centered care through collaboration with patients, families, nurses, social workers, physicians, and other practitioners.
• Secure authorizations and promote the efficient use of healthcare resources.
• Provide a full range of nursing care to meet the comprehensive needs of patients and their families.
• Communicate with third-party payers to obtain authorization for appropriate treatment settings (medical, psych, and chemical dependency).
• Apply clinical knowledge of multiple age groups, medical illnesses, and treatment plans according to disease processes and diagnoses.

Requirements

• Minimum two (2) years of nursing experience in a pediatric care or ambulatory setting.
• Preferred: Three (3) years of nursing experience in an emergency department and/or case management, care coordination, or transition of care.
• Previous pediatric experience and/or management and/or charge nurse role acceptable.
• Graduation with a bachelor’s degree from an accredited University.
• Preferred: Bachelor or master’s degree in Nursing or a health-related field from an accredited University.
• Certification in Case Management (preferred).

Skills

• Ability to work effectively under pressure due to changing priorities, interruptions, high/low census, payor demands, and discharge planning demands.
• Excellent interpersonal communication, including conflict resolution, problem-solving, and negotiation skills.
• Clinical knowledge of multiple age groups, medical illness, and treatment plans according to disease process, diagnosis, and anticipated length of stay (LOS).
• Strong organizational and time management skills, with the capacity to multi-task and prioritize.
• Ability to work independently and exercise sound judgment in interactions with physicians, payers, patients, and their families.
• Proficiency in required competencies upon completion of orientation and maintenance of annual departmental competency requirements.
• Ability to work collaboratively regardless of social, economic, and cultural backgrounds.
• Computer knowledge, including skills in Microsoft Office (Excel, Word, PowerPoint, Access).
• Preferred: Knowledge of CCS/Medi-Cal regulations and requirements.
• Preferred: Knowledge of third-party payor requirements to optimize reimbursement.
• Preferred: Ability to apply severity of illness/intensity of service pediatric criteria to clinical documentation.
• Bilingual in English and Spanish (preferred).

Licensure

• Registered Nurse (RN) – California (required).
• Basic Life Support (BLS) (required).
• Preferred: Certified Pediatric Nurse (CPN).
• Preferred: Certified Case Manager (CCM).
• Preferred: Commission for Case Manager Certification (CCMC).
• Preferred: Valid Pediatric Advanced Life Support (PALS).

Work Environment

• Light to moderate energy level.
• Lift and carry 25-35 lbs.
• Push/pull 50-100 lbs (e.g., empty bed, stretcher).

Physical Activity Requirements

• Bending, carrying objects, climbing, keyboard use/repetitive motion, pinching/fine motor activities, push/pull, reaching forward, reaching overhead.
• Sitting, squatting/kneeling/crawling, standing, talking or hearing, tasting or smelling, twisting, walking, wrist position deviation.
• Lifting (Floor to waist level) – Occasional (0-35%).
• Lifting (Waist level and above) – Occasional (0-35%).

Sensory & Environmental Requirements

• Color discrimination, depth perception, far vision, hearing, near vision.
• Exposure to airborne communicable diseases, bloodborne pathogens, chemicals, dust particulate matter, extreme noise levels, extreme temperatures, radiation, uneven surfaces or elevations.

Pay

Pay Range:
Minimum: $62.22
Midpoint: $62.22
Maximum: $63.24
Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.