RN, Care Manager (Emergency Dept) (Per diem, Day Shift)

Centered in the heart of Montebello, Adventist Health White Memorial Montebello has a 70-year history of providing quality healthcare to the community. We are comprised of a 192-bed hospital, wound care medical office, and surgical and laboratory services. The greater Los Angeles area is known for its art, rich culture, numerous sports teams, and world-renowned dining. There is something for everyone in this culturally diverse community.

About the Role

Establishes, coordinates, and maintains the process to increase patient through-put to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the Emergency Department (ED). Collaborates with the patient/family, multidisciplinary team, physicians, community resources, and payers to ensure the patient’s progress and level of care is appropriately determined for the emergency episode of care and for the inpatient encounter. Ensures care is performed and facilitated in an efficient and cost-effective manner.

Uses well-developed knowledge and skills in patient status determination (InterQual Criteria), assessment, and care management of patients and families within the ED, inpatient, and outpatient settings. Practices include patient/family assessment and management, resource management, identifying patients appropriate for inpatient admission, observation, or outpatient status, care facilitation, discharge planning with referral to all levels of care, and other related duties specific to the defined patient population.

Collaborates with other case managers, social work staff, the access center, admissions, and other physician and administrative leadership staff within the ED, the care management department, and both inpatient and outpatient settings. Uses knowledge of pathophysiology, pharmacology, and clinical care processes to participate with other clinical staff and physicians in the development of clinical practice guidelines and physician order sets to improve quality of care, change practice, and reduce costs.

Responsibilities

• Acts as a resource to ED staff and physicians regarding appropriateness of admission, levels of care (including related documentation requirements and observation vs. inpatient requirements), quality of care concerns, and criteria/guidelines/protocols utilized in care planning and resource utilization.
• Gathers sufficient information from and communicates with all relevant sources to facilitate appropriate discharge from ED to the correct level of care, ensuring it is done accurately, safely, timely, and cost-effectively to prevent readmission and/or frequent ED visits.
• Assists in triaging calls from other acute care facilities requesting patient transfers to EMC; determines transfer appropriateness by reviewing requested documentation, InterQual level of care criteria, and discussions as necessary with admitting physician, supervisors, and/or EMC administrators or other personnel.
• Assesses ED patients and identifies options other than acute hospital admission when appropriate. Screens and refers to acute rehabilitation, long-term acute care hospitals, and nursing homes for admission directly from the ED; screens and refers patients to clinics after initial exam; and screens and refers patients for whom treatments could be safely rendered at home with services (e.g., IV antibiotics, low molecular weight heparin injections, wound care, etc.).
• Organizes, integrates, and evaluates the effectiveness of the plan of care and progress toward achievement of desired outcomes. Modifies plan of care as patient/family needs change to accomplish goals established in the plan of care. Communicates plan of care, including changes and issues, to patient/family, physicians, and other members of the healthcare team.
• Performs other job-related duties as assigned.

Requirements

• Bachelor's Degree in Nursing (BSN): Preferred
• Master's Degree in nursing or healthcare-related field: Preferred
• Experience in case management, utilization management, and/or transitional care: Preferred
• Registered Nurse (RN) licensure in the state of practice: Required
• Accredited Case Manager, Certified Case Manager, or Board Certification in Case Management: Preferred
• Hospital Fire and Life Safety (HLFS) certification: Required

Pay

The estimated base pay for this position is $57.50 to $78.87 per hour. Additional individual compensation may be available for this role through differentials, extra shift incentives, bonuses, etc. Base pay is only a portion of the total rewards package, and a comprehensive benefits program is available for qualifying positions.

Schedule

• Full time
• 12-hour shifts
• Per Diem