Judge Healthcare is currently seeking a Nurse Case/Care Manager - Junior in Murrieta, CA!
This job will have the following responsibilities:
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
Qualifications & Requirements:
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
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.