Registered Nurse/Case Manager

Requirements

• Education: Graduate of an accredited school of nursing. Bachelor's in Nursing preferred.
• Certification & Licensure: RN-Registered Nurse of California.
• Experience: 2 years of recent relevant experience.

Skills and Knowledge

• Broad knowledge of healthcare delivery and case management in a managed care environment.
• Comprehensive understanding of Utilization Review, levels of care, and observation status.
• Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, value-based models, and alternative payment systems preferred.
• Familiarity with laws, regulations, and standards affecting case management practice, including CMS, Title 22, CHA Consent Manual, CDPH, and TJC.
• Understanding of post-acute care levels and regulatory compliance.
• General knowledge of coding and DRG assignment preferred.
• Effective communication and collaboration skills with patients, families, physicians, and healthcare partners.
• Ability to work independently and exercise sound judgment.
• Commitment to service excellence and quality patient care.
• Strong verbal, written, and negotiation skills.
• Excellent time management and organizational skills in a high-volume environment.
• Intermediate computer and technology skills.
• Teamwork and collaboration skills to enhance patient experience.

Schedule

Schedule: M-F, no weekends, no call.