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Keck Medicine of USC

Keck Medicine of USC includes the Keck School of Medicine of USC, the region’s first medical school; the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; the USC Care Medical Group, a medical faculty practice; the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties.

In 2016, U.S. News & World Report ranked Keck Medical Center of USC among the Top 10 hospitals in the state and among the Top 50 hospitals in the United States in seven specialties: ophthalmology, urology, cancer, geriatrics, orthopedic surgery, nephrology and cardiology and heart surgery.

RN Ambulatory Care Manager - VBSO Care Management - FT 8 HR Days

Keck Hospital -VBSO Los Angeles, California

In collaboration with the interdisciplinary team, the Ambulatory Care Manager provides care coordination services evaluating options and services required to meet an individual’s health care needs to promote cost-effective, quality outcomes.  Serves as a consultant to members of the health care team in the management of specific patient populationsThe RN ambulatory care manager role integrates the functions of complex case management, utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services, including transfers to an alternative level of care.

As more complex medical treatment options emerge the Nurse Ambulatory Care Manager will look to eliminate gaps in the care provided, as well as needlessly duplicated treatment, all while controlling the cost of quality patient care. The Nurse Ambulatory Care Manager will leverage their clinical and social work experience to ring an understanding of the clinical process of assessment, planning, implementation, and evaluation to the process of case management.

Some of the major duties of an ambulatory care management nurse include:

  • Documenting patients’ case management plans and on-going activities
  • Identifying patients ‘insurance coverage or other sources of payment for services
  • Identifying and addressing patient risk factors and/or obstacles to care
  • Identifying patient needs, current services, and available resources, then connecting the patient to services and resources to meet established goals
  • Communicating the care preferences of patients, serving as their advocate, and verifying that interventions meet the patient’s needs and treatment goals.
  • Screening patients and/or population for healthcare needs
  • Developing a patient-focused case management plan
  • Educating the patient/family/caregiver about the case management process and evaluating their understanding of the process

Some of the major duties of an ambulatory care management nurse overlap into inpatient duties including:

  • Concurrent review of all patients to validate that the appropriate patient status is assigned upon admission and prior to discharge
  • InterQual or MCG reviews are completed within 24 hours of admission
  • Observation patients are effectively care managed on a daily basis
  • Facilitate throughput and timely discharges throughout inpatient level of care

Minimum Experience/Knowledge:
-Five years+ clinical experience. Two years+ ambulatory case management or utilization review experience within the last three years.

-Prefer of two (2) years+ experience in an HMO/IPA/Managed care setting is preferred and recommended.

Ability to work independently with minimal supervision, exercising judgment and initiative. Ability to manage multiple tasks with effective prioritization. Process oriented. Good computer skills.

Required License/Certification:
-Valid California Registered Nurse license. BCLS Required

-CM and/or UM training and/or certification. Knowledge of CM standards, UM standards, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, and Medicaid/Medicare contracts and benefit systems is preferred.

-Fire and Safety Certification. If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date.

REQ20054207 Posted Date: 01/09/2018

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