RN Case Manager, Acute Care Hospital & Discharge Planning
Overview
Own the case management lifecycle for acute inpatients, coordinating care across the interdisciplinary team at scale. You will assess and reassess patient status, drive utilization review and discharge planning, and advocate for patient self-determination. Work with physicians, nurses, social work, and payer partners to coordinate safe, timely transitions of care. This role is unique for its emphasis on cross-functional collaboration and evidence-based decision support.
What You'll Do8
- 1Build and lead interdisciplinary rounds to align care plans with medical necessity and patient preferences
- 2Design and document discharge plans that optimize transitions of care and reduce avoidable days using evidence-based criteria
- 3Coordinate with community resources, payers, and primary care to facilitate timely transfers and post-hospital services
- 4Identify lower level of care options when appropriate and communicate decisions to patients and families
- 5Provide patient and family education and referrals to support adherence and self-management
- 6Reviews medical necessity and utilization concurrently and communicates to payers and treatment teams
- 7Collaborate with care teams to set goals aligned with physician plans and patient resources
- 8Document discharge assessments and ensure compliance with hospital policy and regulatory requirements
Requirements10
- 1One year of case management or one year of nursing leadership experience
- 2Current California RN license
- 3Knowledge of patient throughput, care coordination, and care planning processes
- 4Computer EMR proficiency and literacy
- 5Knowledge of CMS Medicare Medi-Cal and managed care reimbursement
- 6Familiarity with Joint Commission CMS CDPH requirements
- 7Excellent written and verbal English communication skills
- 8Ability to collaborate across the organization and coordinate with multiple stakeholders
- 9Preferred: Bachelor of Science in Nursing and Certified Case Manager CCM
- 10Preferred: acute hospital case management experience
Salary Insight
$125 - $175k per year
Location
Required Skills
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