Registered Nurse (RN), Case Manager III, Inpatient Care Management - Full-Time/Days (8hrs)
MemorialCare Health System
Location: Long Beach, California
Internal Number: LON009375
Essential Job Outcomes & Functions Care Management
The care manager independently manages a specific case load of patients as identified by the Care Coordination Department. The care manager analyzes patient information and assess each patient’s functional status and decision making ability in relation to the continuum of care and discharge needs. The care manager collaborates with the health care team, patient, and family in planning and facilitating the achievement of expected outcomes for patients. Each treatment plan is evaluated for appropriate quality outcomes and utilization of resources. Continuum of Care/Quality The care manager works collaboratively with the health care team to provide education, resources, and referrals as needed for each patient and their family or care taker.
The care manager facilitates coordination among health care professionals, services, and settings involved in the patient’s care, with a focus on enhancing patient satisfaction. The care manager actively communicates with nursing leadership, CareLine physician directors, and Medical Directors on quality issues. As appropriate, concerns are referred to various Medical Staff Committees and CareLines through required documentation, including but not limited to the Clinical Pertinence Review Form. The care manager has the responsibility to maintain professionalism and provide ongoing education to the health care team regarding the case manager’s role.
Utilization Management: The care manager incorporates knowledge of medical necessity, CareLine protocols, and MAPs to evaluate for appropriateness of admissions, continued stay, and discharges. The case manager refers cases, as appropriate, for review to the Combined Utilization Management Committee and other Medical Staff Committees as needed.