Managed Care - (Full-time, Day-Shift) -
Our mission is to participate in Jesus Christ’s ministry, bringing health, healing, and wholeness to humanity by: Creating a supportive faculty practice framework that allows Loma Linda University School of Medicine physicians and surgeons to educate, conduct research, and deliver quality health care with optimum efficiency, deploying a motivated and competent workforce trained in customer service and whole person care principles and providing safe, seamless and satisfying health care encounters for patients while upholding the highest standards of fiscal integrity and clinical ethics. Our core values are compassion, integrity, excellence, teamwork and wholeness.
The Outpatient Case Manager, Ambulatory, is responsible for coordinating care of the patient/family across the health care continuum. Through multidisciplinary collaboration, care is individualized to enhance achievement of mutually set goals and assure effective and efficient use of resources within fiscal realities. Serves as the link between the patient in the community and the primary care physician to promote seamless, quality care that enhances quality of life. Serves as a broker in obtaining identified resources for the client; focuses on changing from retrospective, episodic case management to a prospective system of health maintenance, disease prevention and management. May be paged after hours and/or on weekends if needed, to meet contractual obligations and provide decision support for managed care issues 24/7. Performs other duties as needed.
Bachelor’s Degree in Nursing required. Minimum of three years’ experience as a registered nurse with two years in Managed Care and geriatric nursing required.
Current California RN license required. Valid Driver’s License required at time of hire. Commission for Case Managers (CCM) Certification preferred.
Able to: read; write legibly; speak in English (and Spanish preferred) with professional quality; use computer and software programs necessary to the position; troubleshoot and calibrate patient care equipment. Able to relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; work independently with minimal supervision; perform basic math functions; manage multiple assignments effectively; work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail. Able to distinguish colors and smells as necessary for patient care; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place/patient care; see adequately to read computer screens, medical records, and written documents necessary to position; discern temperature variances through touch.