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Coordinates utilization management, discharge planning, and post-acute care referrals to provide integrated care for acute patient populations. Focuses on preventing unnecessary readmissions and promoting efficient health service utilization for complex health needs.
Requires a graduate degree from an accredited school of nursing and a valid California RN license. Candidates should have 2 years of recent relevant experience and knowledge of CMS, Title 22, and Joint Commission standards.
We are so glad you are interested in joining Sutter Health!
Job Description:
Other: Graduate of an accredited school of nursing
CERTIFICATION & LICENSURE:
RN-Registered Nurse of California
CCM - Certified Case Manager (certification may be required by entity and time to acquire may be dependent on qualifications for exam)
TYPICAL EXPERIENCE:
2 years recent relevant experience
SKILLS AND KNOWLEDGE:
A broad knowledge base of health care delivery and case management within a managed care environment.
Comprehensive knowledge of Utilization Review, levels of care, and observation status.
Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Title 22, CHA Consent Manual, California Department of Public Health (CDPH) and The Joint Commission (TJC).
A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements.
Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
Demonstrates commitment to service excellence in all patient, family and employee interactions and in performing all job responsibilities.
Functions in a manner to promote quality patient care and assure a positive patient experience.
Verbal and written communication skills.
Interpersonal communication and negotiation skills.
Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
Intermediate computer skills.
Ability to promote teamwork and to effectively function in teams.
Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience.
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $84.50 to $114.34 / hourThe compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.
Sutter Health is a not-for-profit, people-centered healthcare system providing comprehensive care throughout California. Sutter Health is committed to innovative, high-quality patient care and community partnerships, and innovative, high-quality patient care. Today, Sutter Health is pursuing a bold new plan to reach more people and make excellent healthcare more connected and accessible. The health system’s 57,000+ staff and clinicians and 12,000+ affiliated physicians currently serve more than 3 million patients with a focus on expanding opportunities to serve patients, people and communities better. Sutter Health provides exceptional, affordable care through its hospitals, medical groups, ambulatory surgery centers, urgent care clinics, telehealth, home health and hospice services. Dedicated to transforming healthcare, at Sutter Health, getting better never stops. Learn more about how Sutter Health is transforming healthcare at sutterhealth.org and vitals.sutterhealth.org.
Offices: 2200 River Plaza Drive, Sacramento, California 95833, US · 11815 Education Street, Auburn, California 95602, US · 300 Hospital Drive, Vallejo, California 94589, US · 2900 Chanticleer Ave, Santa Cruz, CA 95065, US · 350 Hawthorne Ave, Oakland, California 94609, US
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