RN Care Manager

Job Description

Job Description

Role Summary

Join a dedicated team where your work has a meaningful impact every day. As an RN Case Manager, you will play a vital role in supporting physicians and interdisciplinary teams to enhance patient care, improve clinical outcomes, and optimize healthcare resources. You will be responsible for coordinating care, facilitating transitions, and ensuring patients receive high-quality, cost-effective treatment.

This position offers flexible scheduling, opportunities for professional growth, and a supportive work environment committed to excellence in patient care.

Key Responsibilities

Manage a designated patient caseload, ensuring effective care planning and transitions.

Facilitate precertification and authorization processes with payors.

Collaborate with medical teams to coordinate patient care across the continuum.

Identify and remove barriers to timely and efficient care delivery.

Utilize process improvement methodologies to evaluate patient care outcomes.

Ensure compliance with federal and state regulations, including CMS Conditions of Participation, EMTALA, and The Patient Bill of Rights.

Perform admission, continued stay, and discharge reviews to determine medical necessity and resource utilization.

Partner with healthcare providers and leverage evidence-based practices to enhance patient outcomes.

Other duties as assigned.

Required Qualifications

Associate’s Degree in Nursing (ADN) required.

Current California RN license.

1-3 years of hospital inpatient or related experience.

Ability to effectively coordinate with provider networks, including Health Plans, IPAs, and FQHCs.

Preferred Qualifications

Bachelor of Science in Nursing (BSN).

Certification in Case Management.

Bilingual skills (Spanish preferred).

Basic computer proficiency.

Current Basic Life Support (BLS) certification.

Why Join Us?

Competitive pay : $53.07 - $82.27 per hour.

Flexible scheduling to support work-life balance.

Night shift employees receive a $7.00 per hour differential.

Benefits

No cost medical, dental and vision option, Generous PTO plan, 403(b) employer match, Protective Equipment, Tuition reimbursement, Employee Wellness Program, Onsite childcare, Loan Forgiveness eligible facility, etc.

Work Environment

Full-time positions available.

10-hour daytime shifts