Case Manager, RN

CIBD • Orange, CA

14h • Onsite

About The Position

The Care Manager RN coordinates care and services for patients across the continuum of illness, promotes and monitors effective use of health care resources, and provides leadership within a multidisciplinary care team to support optimal clinical and resource outcomes. The role operates within a Team Center Care model and follows standards and regulations established by California Children’s Services (CCS), the Genetically Handicapped Persons Program (GHPP), the Joint Commission, and other state and federally sponsored programs. The Care Manager RN is a member of the Case Management Team and reports to the Clinic Manager.

The role is based onsite in the Clinic Department and is scheduled Monday through Friday, 8:30 a.m. to 5:00 p.m. The RN collaborates with patients to identify needs and understand care plans, coordinates services with external facilities and providers, and works with internal partners to ensure care and orders are completed. The position also supports patient education, team communication, cross-training, and development of programs for the assigned patient population through outreach, community engagement, committees, and conference attendance.

Requirements

• Graduate of an accredited Registered Nurse (RN) program.
• At least two years of nursing experience in an acute care or ambulatory setting.
• Ability to work onsite; this is not a remote role.
• Active California State Registered Nurse (RN) license.
• Basic Life Support certification, or ability to obtain it within the first three months of hire.
• HIPAA training, or ability to complete it within the first three months of hire.
• Knowledge of standardized nursing procedures in compliance with organizational policies and procedures.
• Solid understanding of regulatory requirements for nursing and clinic licensure.
• Proficiency with electronic medical record databases.

Nice To Haves

• Bachelor of Science in Nursing (BSN).
• At least one year of direct, full-time Case Management experience.
• Knowledge of CCS, GHPP, and Medi-Cal regulations and requirements.
• Knowledge of third-party payer methods and regulations.
• Experience in hematology nursing.
• Experience with adult and pediatric patients.
• Bilingual English/Spanish.

Responsibilities

• Collaborate with patients to identify their needs and ensure they understand their care plans.
• Coordinate patient care with external facilities and services, including home health agencies, third-party payers, pharmacies, and laboratories.
• Work with internal partners, including physicians, nurses, and authorization coordinators, and external providers to coordinate care and fulfill orders from initiation through completion.
• Demonstrate self-direction, strong organization and documentation, and effective written and verbal communication.
• Use computer systems and communication tools to navigate the EMR, submit electronic prescriptions and approval requests, and communicate through email, Zoom, and Microsoft Teams.
• Apply critical thinking and problem-solving skills to address conflicts and resolve issues while providing patient education.
• Promote a comprehensive care team model and become cross-trained as needed to support staffing.
• Maintain communication that fosters positive interpersonal relationships within the team.
• Enhance the program for the assigned patient population through community outreach, engagement with school and community-based organization liaisons, committee participation, conference attendance, and other duties.
• Promote and monitor effective utilization of health care resources.
• Provide leadership within the multidisciplinary care team to support clinical and resource outcomes.
• Adhere to applicable standards and regulations, including those established by CCS, GHPP, the Joint Commission, and other state and federally sponsored programs.

Benefits

• 100% employee medical and vision coverage and 50% dependent medical and vision coverage.
• 99% employee dental coverage.
• Life insurance.
• Paid time off.
• 10 observed paid holidays.
• 403(b) retirement plan with 4% match.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree