Reporting to the Director of Care Management, the Care Manager is responsible for managing the continuum of care from admission through discharge for assigned patients.

The role reflects appropriate knowledge of RN scope of practice, current state requirements, CMS Conditions of Participation, EMTALA, The Patient Bill of Rights, AB1203 and other Federal or State regulatory agency requirements specific to Utilization Review and Discharge Planning.

The Care Manager partners with the medical staff, utilizes scientific evidence for best practices, and relevant data to manage the care of the patient over the continuum of care from pre hospitalization through discharge.

These activities include admission, continued, extended and discharge reviews in all reimbursement categories to determine medical necessity, assure high quality of care and efficient utilization of available healthcare resources, facilities and services.

Qualifications

A.   Education

• Bachelor of Science degree in nursing preferred
• Associates degree in nursing required

B.  Qualifications/Experience

• Minimum of one (1) to three (3) years of hospital or related experience required. Internals with at least 18 months acute care case management/coordination experience will be considered in lieu of nursing clinical experience.   
• Able to navigate and connect successfully with outside provider networks (Health Plans, IPA’s, and FQHC’s).  

C.   Special Skills/Knowledge

• Bilingual language skills preferred (Spanish)
• Basic computer skills 
• Current California Nursing license 
• Current Basic Life Support (BLS) 
• Certification in Case Management preferred. 
• ED Care Managers: Must complete annual Workplace Violence Prevention Program/Certificate, per hospital policy, during initial training/orientation but not to exceed 90 days from hire/transfer.

About the Hospital

Martin Luther King Jr. Community Hospital (MLKCH) is a private, nonprofit, state-of-the-art, safety-net hospital with the mission of bringing the highest quality healthcare to the historically underserved communities of South Los Angeles. Since we opened our doors in 2015, we have made a meaningful impact on the lives and health of our neighbors. Come work with us.