RN Patient Care Coordinator - Case Manager 03:00 PM to 11:30 PM Coordinateswith physicians, staff and providers and facilities regardingpatients' transitions and discharge planning. In conjunction with physicians,develops plans of care and discharge plans, and makes recommendations foralternative levels of care as required. EssentialResponsibilities (The primary job duties this position is responsible forachieving are listed in order of importance.) + UtilizationManagement: Performs daily pre-admission, admission, and concurrent utilizationreviews using guidelines, institutional policies/procedures, and otherinformation to determine appropriate levels of care and readiness for discharge.Monitors the progression of the discharge plan and facilitates discussions withthe multidisciplinary teams. + Educatesother healthcare team members on utilization and care coordination. + Collaborateswith and provides information to patients, families, physicians, and staffregarding the discharge plans and transitions + Understandsand consistently applies the interpretation, and utilization of member healthcare benefits. + ConductsUM, care coordination and discharge planning activities according to allapplicable regulatory requirements. + DischargePlanning: Ensures continuity of care through communication in rounds andwritten documentation, level of care recommendations, transfer coordination,discharge planning and obtaining authorizations/approvals as needed for outsideservices for the patient. + Develops,evaluates, and coordinates a comprehensive discharge plan in conjunction withthe patient/family, physician, nursing, social services, and other health careproviders and agencies. + Regulatory:Conducts UM, care coordination, and discharge planning activities according toall applicable regulatory requirements. Minimum Education: + Graduate of accredited school of nursing. + Diploma/Associate Degree Nursing. Basic Qualifications: + Minimum four (4) years of experience in hospital patient care delivery, OR completion of Master's degree in case management program in lieu of minimum years of experience, Additional Requirements: + Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPPA, ERISA, EMTALA & all other applicable federal/state/focal laws & regulations. + Demonstrated strong communication and customer service skills, problem-solving, critical thinking, & clinical judgment abilities + Fundamental word processing & computer navigation skills & the ability to interpret & use analytic data in day to day operations, + Knowledge of health care benefits associated with various business line (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal, etc.) + Must be able to work in a Labor/Management Partnership environment. Licenses and Certifications: + Registered Nurse License (California) + Basic Life Support Preferred Qualifications: + Minimum two (2) years of experience in utilization review, case management, and discharge planning preferred. + Bachelor's degree in nursing or a health care related field preferred. + Master's degree in case management preferred. Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: + Competitive pay & weekly paychecks + Health, dental, vision, and life insurance + 401(k) savings plan + Awards and recognition programs *Benefit eligibility is dependent on employment status. About Amergis Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions. Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.