At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.
Under minimal supervision and in a professional manner, the Registered Nurse inpatient case manager performs all job duties to the highest level of customer service and assistance to both internal and external customers of MemorialCare Medical Foundation. This position requires exceptional clinical and communication skills in support of patients, their care givers and providers when seen at or admitted to the acute care setting. The nurse case manager is required to meet all elements as required by hospital governing bodies as well as managed care delegation requirement for this position to ensure appropriate admissions, ongoing concurrent treatment, discharge planning and transitions of care for the populations served. The position is critical to the organization’s inpatient utilization and quality outcomes for populations we manage.
Current California Registered Nurse license (RN)
Work experience applying evidence-based criteria (i.e.: MCG, lnterqual); Health plan medical policy / clinical coverage guidelines
Knowledge of CMS (Centers for Medicare and Medicaid Services) coverage policies required
Inpatient nursing or related field required
Associate's degree (AA) in nursing or equivalent from a two-year college or technical school.Work experience in Microsoft Word, Microsoft Excel and Microsoft Outlook
Previous inpatient Case Management experience preferred
Previous and or ability to learn use of electronic medical record, UM/CM platforms or electronic health record preferred
Bachelor of Science in Nursing, Social Worker or equivalent preferred
Internal Number: MEM003668
About MemorialCare Medical Foundation
Let us introduce ourselves. We're MemorialCare, a nonprofit health system that includes four hospitals, two medical groups, imaging centers, surgical centers and much more. As one of the leading health systems in Orange County and Los Angeles County, we're confident that no matter what your needs are, we have the teams, tools and know-how to support you every step of the way.