Orthopedic Nurse Case Manager for BCP - Full-time / Part-time

The Ambulatory Orthopedic Nurse Case Manager plays a vital role in providing patient-centered case management to patients with orthopedic conditions across the continuum of care settings; in close collaboration with participating physicians and their teams.

The case manager is a member of a multidisciplinary team, working with their Supervisor, Manager, Director, and Managed Care Medical Director to attain optimal results by impacting the delivery of quality care in a holistic approach to the patient and family. They coordinate care with providers, staff, external providers and facilities.

Education/Certification/Licensure (enter the degree or certification, registration, licensure type in the appropriate box)

HS Diploma

Associates

Bachelors

Masters

Other

Cert/Reg/Licensure

Required

X

• See Experience

Desired

X

or Equivalent Ed/Exp

X

Experience (number of years and type of work experience/environment needed to be fully proficient in the job. This should reflect the minimum requirement, unless noted as preferred).

REQUIRED

• Active, unrestricted CA RN license , Current, unrestricted CA Drivers License
• Current, BLS certification
• BSN from an accredited US nursing program
• Minimum of three (3) years acute care nursing experience
• Case management, home care, or discharge planning experience required – minimum one year

PREFERRED:

• Case management certification, or expected to attain CCM (case management certification) within two years of hiring.
• Experience working in EPIC and EPIC Tapestry
• Public Health Nursing Certification

Knowledge (information gained through education or experience that incumbent would draw upon to perform this job. This should reflect the minimum requirement, unless noted as preferred).

• Knowledge of orthopedic conditions and surgical treatment options and its effects on patients and caregivers.
• Computer skills including Microsoft Office. EPIC knowledge preferred.
• Knowledge of applicable NCQA standards, state and federal regulations.
• 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.