This list contains only the countries for which job offers have been published in the selected language (e.g., in the French version, only job offers written in French are displayed, and in the English version, only those in English).
Rady Children’s nurses serve as local and global leaders in shaping how care is delivered to patients and families throughout our organization and in the communities we serve. Behind each nurse and their leader is the commitment to learn more, improve outcomes and empower individuals to seek innovative solutions. We are transforming the role of the caregiver, and in that transformation, we are partners in advancing the quality of care. Every day, we look for new pathways. It is a journey of excellence. It’s not just caring about children that makes our nursing staff so special. It’s the magic! Our dedication to specialized training and sensitivity is perfected by caring for children 100% of the time. Rady Children’s is designed, equipped and staffed just for kids. As the region’s only pediatric trauma center, we care for children with the most severe medical emergencies to those with mild illnesses. Rady Children's offers competitive salaries, robust benefits, generous paid time off, retirement savings with contribution match, employee recognition, Team Rady events and celebrations, along with other great perks. Join us in sunny San Diego!
Job Responsibility
Case Managers function as liaisons between patients, their families, payors, and healthcare personnel to ensure appropriate movement along the continuum of care
Their focus includes coordinating discharge needs, quality of care, and implementing the utilization management process for acute inpatients
Case Managers perform concurrent review and denials management based on acute care guidelines with a focus on authorization and reimbursement, appropriateness of admission, length of stay, and avoidable delays in discharge
The Case Manager collaborates with the family, the care team, third party payors, and outside providers to coordinate discharge needs including home health, durable medical equipment, and safe transitions of care
Requirements
BLS for Health Providers (American Heart Association)
California RN License
Bachelor's Degree in Nursing
4 years nursing in an acute hospital or 2 years Case Management, Utilization Review, or Discharge Planning experience in an acute hospital
Nice to have
Experience in a pediatric acute hospital
Familiarity with Interqual or Milliman Care Guidelines
Experience navigating the electronic medical record (Epic)
What we offer
Health Plan
Medical, Dental, Vision
403(b) Retirement Plan
Match that increases with years of service
Tuition Reimbursement
Up to $10,000 per year, paid time off for seminars