RN, Care Manager

Job Description
Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital, three medical office buildings, residency programs, comprehensive cancer care and a vast scope of services located in the Los Angeles area. In 2019, Adventist Health White Memorial was recognized with the Malcolm Baldrige National Quality Award, the nation's highest presidential honor for performance excellence. We are proud to promote wellness in the community at the local farmers market and through our community resource center with services for seniors and Spanish-speakers. Los Angeles is known for its art, rich culture, numerous sports teams and world-renowned dining. There is something for everyone in this culturally diverse city.

Job Summary
Establishes, coordinates, and maintains the process to increase patient through-put to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the Emergency Department (ED). Collaborates with the patient/family, multidisciplinary team, physicians, community resources and payers to ensure the patient's progress and level of care is appropriately determined for the emergency episode of care and for the inpatient encounter to ensure that care is performed and facilitated in an efficient and cost-effective manner. Uses well developed knowledge and skills in patient status determination (InterQual Criteria), in the assessment and care management of patients and families within the ED, inpatient and outpatient settings. Practices patient/family assessment and management, resource management, identifying patients appropriate for inpatient admission, observation, or outpatient status, care facilitation, discharge planning with referral to all levels of care, and other related duties specific to the defined patient population. Collaborates with other case managers, social work staff, the access center, admissions, and other physician and administrative leadership staff within the ED, the care management department and both the inpatient and outpatient settings. Uses knowledge of pathophysiology, pharmacology, and clinical care processes to participate with other clinical staff and physicians in the development of clinical practice guidelines and physician order sets for the purpose of improving quality of care, changing practice, and reducing costs.

Job Requirements
Education and Work Experience:

• Bachelor's Degree in Nursing (BSN): Preferred
• Master's Degree in nursing or health care related field: Preferred
• Experience in case management, utilization management, and/or transitional care: Preferred

Licenses/Certifications

• Registered Nurse (RN) licensure in the state of practice: Required
• Accredited Case Manager, Certified Case Manager, or Board Certification in Case Management: Preferred

Facility Specific License/Certifications

• Hospital Fire and Life Safety (HLFS): Required

Essential Functions

• Acts as a resource to ED staff and physicians regarding appropriateness of admission, levels of care (including related documentation requirements and observation vs. inpatient requirements), quality of care concerns and criteria/guidelines/protocols utilized in care planning and resource utilization.
• Gathers sufficient information from and communicates with all relevant sources to facilitate appropriate discharge from ED to appropriate level of care to assure it is done in an accurate, safe, timely and cost-effective manner to prevent readmission and/or frequent visits to ED.
• Assists in triaging calls from other acute care facilities requesting patient transfers to EMC; determines