Judge Healthcare is currently seeking a Nurse Case/Care Manager - Junior in Murrieta, CA!
This job will have the following responsibilities:
Qualifications & Requirements:
- Daily onsite rounds reviewing of medical records concurrent review and discharge planning on inpatients with arrival at facilities in the morning ideally between 8-9am
- Daily inpatient rounds with hospitalist
- Document Milliman Guidelines on every inpatient case as well as update in notes/system NE
- Analyzes medical cases for appropriateness and plans and coordinates all phases of care in conjunction with the hospitalist attending physician specialists both in the inpatient and outpatient setting.
- Utilizes the nursing process to establish individual patient goals and measures patients response to the plan of care for appropriate outcomes and intervenes appropriately.
- Collaborates with physicians patients and families to formulate an optimal plan of care that meets all of the medical psychosocial and financial needs of the patient
- Understands capitation versus fee for service
- Knowledgeable with contracts able to communicate with Health Plans Participates in IPA grand rounds providing a concise history and overview of members/patients progress and discharge plan.
- Other duties as assigned
- LVN or RN Level of Experience 2-4 years clinical experience in acute care or related health care experience or managed care experience
- Knowledge skills: Computer literate in Micro Soft word Knowledge of general IP/PMG
- Operations Flexible and adaptable Able to problem solve and make decisions independently.
Associated topics: ambulatory, bsn, care, care unit, ccu, coronary, hospice, neonatal, nurse clinical, tcu