RN Case Manager Full Time Days

CHA Hollywood Presbyterian Medical Center

CHA Hollywood Presbyterian Medical Center (HPMC) is an acute care facility that has been caring for the Hollywood community and surrounding areas since 1924. The hospital is committed to serving local multicultural communities with quality medical and nursing care. With more than 500 physicians representing virtually every specialty, HPMC strives to distinguish itself as a leading healthcare provider, recognized for providing quality, innovative care in a compassionate manner.

HPMC is part of a global healthcare enterprise which owns and operates general hospitals throughout Korea, numerous research centers in the U.S. and Korea including a medical university, and CHAUM (a premier anti-aging life center).

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  Assessing all patients based on appropriate criteria (severity of illness/intensity of service) for acute care and admission in appropriate setting (ICU, Med/Surg, OB, Peds, Rehab)
• Interviewing the patients or significant others to identify post hospital care needs within a timely manner and arrange ancillary service needs identified (HHC, HME, Hospice, transport, etc).
• Coordinating patient transfers between facilities.
• Assessing the patient for appropriate level of care using the Severity of Illness/Intensity of service criteria.
• Referring appropriately to allied health personnel and community resources.
• Providing clinical consultation on difficult cases or initiates multidisciplinary care consultations as needed relating to acute care or alternative levels of care.
• Exhibiting open communication with physicians and Physician Advisors to facilitate discharge plans and provide the highest quality of care using established criteria.
• Serving as a resource for physicians, hospital staff, and outside agencies in reference to insurance criteria and governmental regulation.
• Delivering letters of denial, re-determination, and/or referrals to patients, MDs, and billing office upon notification.
• Assisting nursing in communicating to Health Department regarding TB screening for authorized discharges.
• During interview process may need to assist patient (turn, lift up, etc.).
• Maintaining confidentiality of departmental and patient’s information.
• Demonstrating knowledge of age specific care, including but not limited to, identifying the need for additional safety measures, physiological normal values/readings; and assessing skin integrity, behavior, motor skills and/or activities that place patients at risk as well as communicates effectively in a clear, concise, understandable manner. Applicable for all populations, infant, pediatric, adult, geriatric.
• Pulling files for TARs requested by Physicians required for billing.
• Appealing errors discovered in authorization process relative to payer's criteria and process.

• Graduate of an accredited RN Program

• Completion of Case Management Course Preferred

• Minimum two years’ experience as a RN in an acute care setting.
• Ability to communicate effectively verbally and in writing.
• Must be able to work in a union environment.

• Minimum two years as a Case Manager Preferred.

• BLS Card
• Current Los Angeles County Fire Card required (within 30 days of employment).

Disclaimer, Compliance and Service Language:

DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by incumbents assigned to this job. This is not intended to be an exhaustive list of all the responsibilities, duties and skills required. The incumbent may be expected to perform other duties as assigned.

COMPLIANCE & INTEGRITY: Consistently supports compliance and the Hollywood Presbyterian Medical Center's Code of Conduct by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licensure requirements (if applicable), and Hollywood Presbyterian Medical Center's policies and procedures.

Models and reinforces ethical behavior in self and others in accordance to the Code of Conduct; adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty; shows consistency in words and actions; follows through on commitments. All Directors, Managers and Supervisors are accountable for communication, implementation, enforcement, monitoring and oversight of compliance policies and practices in their departments.

SERVICE & QUALITY: In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Hollywood Presbyterian Medical Center, as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our patients, and to purchasers, contracted providers and vendors.

WORKPLACE SAFETY: In addition to defined working conditions and physical requirements, employees are accountable for working safely; following established policies & procedures; utilizing all designated protective personal equipment (PPE) and/or safety equipment assigned for task; and reporting all injuries and hazards to their supervisor immediately. Supervisors and Managers are accountable for ensuring the safety performance of employees; applying consistent practices in compliance with federal, state and local regulations; providing guidance to maintain a safe and healthy work environment.

Hollywood Presbyterian Medical Center is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the Los Angeles Fair Chance Ordinances.