Case Manager II, Ambulatory Registered Nurse Neurosciences Limited Term

Sutter Health•Berkeley, CA

1d•$83 - $109

About The Position

Provides patient-centered case management to patients with chronic illness, complex medical conditions and who are in transition across the continuum of care settings. As a member of an interdisciplinary team coordinates care in accordance with the plan of care, to achieve optimal results by impacting the delivery of quality care in a holistic approach to the patient and family. Provides assessment, treatment, intervention, patient education and patient management for adult/child patients and their families based on approved standard protocols and within scope of practice. EPIC experience and knowledge of insurance is a requirement of this role.

Requirements

EDUCATION: Graduate of an accredited school of nursing
CERTIFICATION & LICENSURE: RN-Registered Nurse of California
BLS-Basic Life Support Healthcare Provider
TYPICAL EXPERIENCE: 2 years recent relevant experience
SKILLS AND KNOWLEDGE: Comprehensive knowledge of a broad range of medical diagnoses, treatment modalities, therapeutic services and intervention techniques, and knowledge of hospital and/or ambulatory practices and procedures
NCQA standards and application, state and federal requirements as apply to managed care, utilization management criteria and its application
Knowledge of the health care financial environment and requirements for various payer types, e.g., Commercial, CMS, CCS for HMO and PPO cases, and ability to apply Managed Care concepts
Interpersonal skills collaborating with physicians, patients, families, care givers, service providers, and health care team
Must exhibit, clear oral and written communication skills, including the ability to effectively organize ideas and data for logical presentation and acceptance by staff, flexibility and knowledge in problem solving activities
Demonstrated, positive interpersonal relationship skills, to include presentations to small groups, and skill in time management
EPIC experience
Knowledge of insurance

Responsibilities

Coordinates care in accordance with the plan of care
Provides assessment, treatment, intervention, patient education and patient management for adult/child patients and their families based on approved standard protocols and within scope of practice.