Sutter Health
CaseManagerII,RegisteredNurse
“Case Manager II, Registered Nurse at Sutter Health. Skills: Care Coordination, Care Transitions Planning, resource coordination. Responsible for Care Coordination. Care Transitions Planning”
What You'll Achieve.
achievement of optimal health; access to care; appropriate utilization of resources; promote quality patient care; assure a positive patient experience
Industry & Context.
Ability to work independently and exercise sound judgment
What They're Looking For.
Must Have
RN-Registered Nurse of California Upon Hire, 5 years recent relevant experience
Nice to Have
CCM certification preferred, Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, value-based reimbursement models, and alternative payment systems preferred, General understanding of coding and DRG assignment process preferred
What You'll Do.
Responsible for Care Coordination
Care Transitions Planning
assure the timely progression and transition of patients
prevent unnecessary admissions or readmissions
facilitates care across the continuum
achievement of optimal health
appropriate utilization of resources
address complex clinical and social situations
How You'll Work.
Team & Collaboration
works in collaboration with the Physician; works in collaboration with the Utilization Manager; works in collaboration with the Medical Social Worker; works in collaboration with the bedside RN; collaborates with patients, families, physicians; collaborates with the interdisciplinary team; collaborates with nursing management; collaborates with quality; collaborates with ancillary services; collaborates with third party payers; collaborates with review agencies; collaborates with claims and finance departments; collaborates with Medical Directors; collaborates with contracted providers; collaborates with community resources; promote cooperation and collaboration between individuals; promote teamwork; effectively function in teams; interact effectively with key internal and external constituents
Communication Scope
verbal and written communication skills; negotiation skills
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