Care Manager I : Care Management - Full Time - 08HR - Hoag Newport Beach (Utilization Review)

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Care Manager I : Care Management - Full Time - 08HR - Hoag Newport Beach (Utilization Review)

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Primary Duties and Responsibilities

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The Care Manager (RN/MSW) coordinate patients’ needs through the continuum of care which can include from pre-admission through post discharge plans. This role works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care.

Job Description

Primary Duties and Responsibilities

The Care Manager (RN/MSW) coordinate patients’ needs through the continuum of care which can include from pre-admission through post discharge plans. This role works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care.

Reviews clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive care and/or discharge plans. May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support.

May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing. May provide psychodynamic intervention and crisis counseling to support patients and families. Educates patients and families on their healthcare options and connects them with resources.

Documents pertinent patient issues, contacts and plans on the medical records. Is a mandated reporter for elder, child, and spousal abuse. The Community Care role specifically provides Care Management support to high-risk, homeless and mental health population. Performs other duties as assigned.

Community Health: The Care Manager/ Social Worker (MSW) provides care in the outpatient environment and surrounding community as dictated by Community Benefit parameters. Coordinates and provides care that is safe, timely, effective, efficient, equitable, and client centered.

Manages the client needs through the continuum of care which can include intake through case termination plans. Assesses patients' needs including financial, family and psychosocial support, and develops tailored care plans.

Records client progress including referrals, home visits, and other notable interactions; periodically evaluate client’s progress and adjusts to improve outcomes. Collaborates with the Center for Healthy Living staff, partner agencies, and other community agencies as needed.

Provides care to higher acuity patients and works with team members to arrange for appropriate resources. May provide psychodynamic intervention and crisis counseling to support clients. Facilitates psychoeducational groups as needed.

Assists in training interns, collecting data to measure program outcomes. Performs other duties as assigned.

Qualifications

Education and Experience

Positions Requirements Depend On Licensure And Are As Follows

Case Manager (RN) – Bachelor’s degree in Nursing (BSN) required. Care Manager (RN)s at Magnet designated facilities only require a BSN or that a BSN program is started within one year of hire date and BSN degree is attained within two years of the starting the BSN program. One year of experience in an acute health care setting preferred.

Care Manager (MSW) – Master’s degree in Social Work (MSW) required. One year of MSW experience in an acute healthcare setting preferred.

Community Health: Master’s degree in Social Work (MSW) required. One year of MSW experience in community case management preferred. Understands working with the low income and under resourced community. Must be a licensed driver with an automobile that is insured in accordance with state and/or organization requirements and is in good working order. Bilingual or multilingual preferred.

License Required

• Registered Nurse (RN) license - for Care Manager I (RN) position
• Community Health: CA Driver’s License
  
  

License Preferred

N/A

Certifications Required

N/A

Certifications Preferred

N/A

About Us

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, .

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.Seniority level

• Seniority levelEntry level

Employment type

• Employment typeFull-time

Job function

• Job functionHealth Care Provider
• IndustriesHospitals and Health Care

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