Casa Colina Hospital and Centers for Healthcare Pomona, CA, USA
The goal of case management is the provision of quality and cost-effective healthcare services to patients admitted to the facility from the point of their admission and across the continuum of the health care management. The nurse case manager realizes this goal by organizing healthcare services to promote optimal outcomes for the individual. The process includes planning, organizing, coordinating, and monitoring the services and resources needed to respond to the individual’s healthcare needs. 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 in order to support medical necessity for the hospitalization of the patient. Must possess California Registered Nurse (RN) licensure, education in nursing (Associates/ BSN) from an accredited school, current CPR certification and update annually. Experience with InterQual required. The ideal candidate will have familiarity with the resources available regarding the regulations and parameters of third-party reimbursement, excellent communication skills, experience and knowledge in basic to intermediate computer skills, strong organizational skills and attention to detail, ability to prioritize and work independently. The preferred skills of the ideal candidate are bilingual capabilities, one (1) year experience in case management, discharge planning or nursing management, three (3) to five (5) years acute care nursing clinical experience, and knowledge of Milliman criteria and InterQual Criteria.
Nov 11, 2019