Prime Healthcare

Case Manager - Utilization Management - RN

Facility St. Francis Medical Center
Location
US-CA-Lynwood
ID
2022-103145
Category
RN
Position Type
Full Time
Shift
Evenings
Job Type
Non-Exempt

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! St. Francis Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

 

St. Francis Medical Center is one of the leading comprehensive healthcare institutions serving Southeast Los Angeles. St. Francis is dedicated to providing vital healthcare services for the 700,000 adults and 300,000 children who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Maternal-Child Health, Behavioral Health and Emergency and Trauma Care.  In addition, the hospital offers a broad array of education and outreach programs that advance community health. St. Francis Medical Center is a Certified Primary Stroke Center, Approved STEMI Receiving Center for Los Angeles County and designated Baby-Friendly healthcare facility by Baby-Friendly USA. Please visit www.stfrancismedicalcenter.com for more information.

Responsibilities

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

Qualifications

Education and Work Experience

  1. Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
  2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.
  3. Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred.
  4. Current BCLS (AHA) certificate, preferred.
  5. Knowledge of Milliman Criteria and InterQual Criteria preferred.
  6. Experience and knowledge in basic to intermediate computer skills.
  7. Behavioral Violence Prevention Training within 3 months of hires and maintain current.

 

We are an Equal Opportunity/Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law:  https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf

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