RN Case Manager II, Acute Float

Company: Sutter Health
Location: Los Altos
Posted on: May 23, 2025

Job Description:

We are so glad you are interested in joining Sutter Health!OrganizationPAMF-Palo Alto Medical Foundation PADPosition OverviewConducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted criteria for ambulatory, acute, and post-acute patients to confirm medical necessity is met and at the appropriate level of care. Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation. Strives to promote patient wellness, improved care outcomes, and efficient utilization of health services among a patient population with complex health needs.EducationJob Description:Associate Degree in NursingOther: Graduate of an accredited school of nursingCertification & LicensureRN-Registered Nurse of CaliforniaBLS-Basic Life Support

• A plus to have CCM - Certified Case Manager (certification may be required by entity and time to acquire within 2 years of hire)This Position Will Float Between Several HospitalsGood Samaritan Hospital2425 Samaritan DrSan Jose, CA 95124El Camino Hospital2500 Grant RdMountain View Ca 94040Washington Hospital Healthcare System2000 Mowry AveFremont, Ca 94538Stanford Hospital300 Pasteur DrPalo Alto, CA 94305Typical ExperienceTwo years recent relevant experienceSkills And Knowledge
  • A broad knowledge base of health care delivery and case management within a managed care environment.
  • Comprehensive knowledge of Utilization Review, levels of care, and observation status.
  • Working knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care, National Committee for Quality Assurance (NCQA).
  • A broad knowledge base of outpatient, acute, and post-acute levels of care and associated regulatory compliance requirements.
  • Must be able to effectively communicate with and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners.
  • Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
  • Demonstrates commitment to service excellence in all patients, family, and employee interactions and in performing all job responsibilities.
  • Functions in a manner to promote quality patient care and assure a positive patient experience.
  • Verbal and written communication skills.
  • Interpersonal communication and negotiation skills.
  • Must have time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
  • Intermediate computer skills.
  • Ability to promote teamwork and to effectively function in teams.
  • Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience.Job ShiftDaysScheduleFull TimeShift Hours8Days Of The WeekMonday - FridayWeekend RequirementsAs NeededBenefitsYesUnionsNoPosition StatusNon-ExemptWeekly Hours40Employee StatusRegularSutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.Pay Range is $79.02 to $104.27 / hourThe salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.

Keywords: Sutter Health, Santa Rosa , RN Case Manager II, Acute Float, Executive , Los Altos, California