Care Managment RN
About The Position
The Care Management RN provides clinical care management services to assigned patients, with a focus on coordinating care, supporting transitions, addressing barriers, and promoting appropriate utilization of healthcare resources. The RN conducts clinical case reviews, develops and updates individualized care plans, performs patient outreach and follow-up, and collaborates with providers and interdisciplinary teams to support quality outcomes, continuity of care, and patient satisfaction. The role performs duties in accordance with established department procedures, clinical criteria, health plan requirements, and applicable regulatory standards.
Requirements
- High school diploma or equivalent.
- Graduate of an accredited Registered Nursing Program.
- 2+ years of Registered Nursing experience in care management, utilization management/review, ambulatory care, or a related managed care or healthcare setting.
- Active, unrestricted California Registered Nurse (RN) license.
- Ability to type 40 words per minute with accuracy.
- Proficient in Microsoft Office (Word, Excel, Outlook, Access, PowerPoint).
- Excellent written and verbal communication skills.
- Ability to assess and analyze clinical information, apply established criteria, identify barriers to care, and support program compliance.
- Strong organizational skills and the ability to manage multiple priorities.
- Ability to work independently and collaboratively within an interdisciplinary, patient-centered environment.
Nice To Haves
- Bachelor’s degree in Nursing or related healthcare field.
- Previous ambulatory care management, case management, or managed care experience.
Responsibilities
- Provides clinical care management services to assigned patients.
- Coordinates care, supports transitions, addresses barriers, and promotes appropriate utilization of healthcare resources.
- Conducts clinical case reviews.
- Develops and updates individualized care plans.
- Performs patient outreach and follow-up.
- Collaborates with providers and interdisciplinary teams to support quality outcomes, continuity of care, and patient satisfaction.
- Performs duties in accordance with established department procedures, clinical criteria, health plan requirements, and applicable regulatory standards.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
