At Natividad, our dedication to the people of Monterey County is at the heart of everything we do—from the health care services we provide to the specialized programs we promote. This commitment to our community spans more than 130 years and, more importantly, has touched countless lives. It has also earned us a Joint Commission ranking in the top percentile of hospitals nationwide. If you believe in inspiring healthy lives by focusing on community-based care, consider joining Natividad today.
CASE MANAGEMENT NURSE
Natividad is currently seeking to fill one permanent, full-time Case Management Nurse position in the Utilization Management Department. Under direction, the incumbent performs care management utilization review and/or patient discharge/transfer care coordination on assigned units; identifies potential or existing utilization review and patient discharge/transfer planning problems and facilitates resolutions; and performs other related work as required.
Requires completion of an accredited nursing program with a valid CA Registered Nurse License and one year of experience performing utilization review and/or discharge planning duties in an acute-care hospital setting OR three years of experience as a Registered Nurse in an acute care hospital setting on a Medical/Surgical unit, with at least one year in a charge nurse role.
The ideal candidate will have thorough knowledge of:
Community resources, payer sources and means by which to manage them in order to achieve the required continuum of care/services after discharge
Hospital Ambulatory Services routines, organization and dynamic interrelationships
Common disease stages, sequences, progression, processes and resulting treatment plans found frequently in acute care and/or extended care settings
Follow-up care, equipment and patient needs upon/after discharge
Principles, practices and theories of acute and/or ambulatory-care management, utilization review and discharge planning
Joint Commission standards and requirements pertaining to utilization review and discharge planning
Medicare regulations, reporting requirements, review practices and funding of outpatient services
Medi-Cal regulations addressing prior authorization, concurrent review, reimbursement and funding of outpatient services
Natividad fosters a culture of service excellence and seeks candidates who have demonstrated the ability to provide and continually improve the responsiveness of that service. The Human Resource department takes a leadership role in implementing Natividad's customer service program. Customer service relations at Natividad recognizes, respects, and understands the rich diversity of the health care environment.