CASE MANAGER - ADMISSIONS

Scripps is a not-for-profit, community-based health care delivery network in San Diego, California, that includes five acute-care hospitals, more than 2,600 affiliated physicians, an extensive ambulatory care network, home health care and associated support services. As a result of the July 2000 reaffiliation with Scripps Clinic, Scripps now has approximately 10,000 employees and also cares for patients at 12 Scripps Clinic locations throughout San Diego County.Division: Scripps HospitalsDepartment: FINANCEJob Type: Full-TimeShift Type: DaysShift Hours: VariesPosition Profile: The goal of the Admissions Case Manager is to ensure delivery of optimal service while promoting fiscal responsibility. Ensures the daily operations, procedures and standards of care are maintained in accordance with hospital and county guidelines. Participates in the coordination and direction of the admissions process for patients. The Admissions Case Manager must be prepared to address the issues of medical necessity and appropriate level of care. The role requires the nurse to have an understanding of financial reimbursements and third party payments. Acts as a resource to Access and medical staff. Coordinates and promotes an advanced level of nursing care for admission or transfer. Utilizes critical thinking, interpersonal and technical skills within the patient admission process. Participates in data collection as required. Demonstrates ability to perform competencies as outlined in Admissions Case Manager Competency Assessment tools.SCRIPPS VALUESWe provide the highest quality of service.Scripps is committed to putting the patient first and quality is our passion. In the new world of health care, we want to anticipate the causes of illness and encourage health behavior for all who rely on us for service. We teach and encourage patients to participate in their care and to make well-informed decisions. We will be their advocate when they are most vulnerable. We measure our success by our patients’ satisfaction, their return to health and well-being, and our compassionate care for dying patients, their families ad friends.We demonstrate complete respect for the rights of every individual.Scripps honors the dignity of all persons, and we show this by our actions toward one another and those we serve. We embrace the diversity that allows us to draw on the talents of one another. We respect and honor the cultural, ethnic and religious beliefs and practices of our patients in a manner consistent with the highest standards of care. All this is done in a compassionate setting. Our goal is to create a healing environment in partnership with all caregivers who are committed to serving our patients.We care for our patients every day in a responsible and efficient manner.Scripps serves as a major community health care resource for San Diego County and, as such, we are accountable for the human, financial and ecological resources entrusted to our care as we promote healing and wholeness. We begin from a base of excellence and collaborate with co-workers, physicians, patients, and other providers to find new and creative ways to improve the delivery of health care services. All members of our community will have access to timely, affordable and appropriate care.
REQUIREMENTS
Preferred Qualifications: POSITION QUALIFICATIONS AND REQUIREMENTS: List the minimum qualifications/requirements necessary to adequately perform this position.
Experience/Specialized Skills:
3 to 5 years previous acute care clinical experience preferred. Three years experience in case management/utilization review, discharge planning or home health case management preferred. The candidate will possess superior critical thinking and clinical skills and be capable of high level fiscal and clinical assessment. Knowledge of various reimbursement methodologies preferred. Possesses complex problem solving skills, the ability to manage conflict, and to respond to significant amounts of sensory stimuli. Have excellent written and verbal skills; must be able to relate positively to the multi-disciplinary healthcare team. Must be adaptable and flexible.Required Education/Course(s)/Training:
Bachelor’s degree in nursing strongly encouraged. Master’s degree in nursing or related field preferred.Required Certification/Registration:
Current California Registered Nurse License. BLS preferred. CCM-CPUR encouraged.