RN Care Manager - Gastroenterology

CHOC • Orange, CA

12d • $53 - $87 • Onsite

About The Position

The RN Care Manager – Gastroenterology delivers care coordination services for patients in a clinic setting. The role plans and delivers family-centered care through collaboration with patients and families, nurses, social workers, physicians, other practitioners, caregivers, and community partners. The RN communicates effectively, facilitates care across the continuum, advocates for patients, supports access to care, and helps ensure appropriate use of resources. The role provides a full range of nursing services and helps meet the comprehensive care needs of patients and their families. The position is eligible to be paneled by CCS to provide collaborative, comprehensive care in a multidisciplinary setting.

The role requires strong clinical knowledge and nursing expertise in managing complex pediatric and specialty populations. The RN uses communication, collaboration, relationship-building, resilience, adaptability, critical thinking, and leadership to engage stakeholders, navigate healthcare systems and managed care requirements, support care planning and coordination, and promote quality outcomes. The position serves as a patient and family advocate, supporting equitable access, smooth transitions, and optimal health outcomes. Experience with medically complex patients, gastrointestinal conditions, and gastroenterology specialty practices is preferred.

This position is located in Orange, California, and works an 8-hour day shift. The listed pay range is $52.93 to $87.32; the rate is determined by factors including knowledge, skills, competencies, experience, education, and position requirements.

Requirements

• At least two years of nursing experience in pediatric care or an ambulatory setting.
• Bachelor's degree in nursing from an accredited university.
• Current Basic Life Support (BLS) certification.
• Registered Nurse license in California (RN).
• Ability to work effectively under pressure amid changing priorities, interruptions, census changes, payer demands, and discharge-planning demands.
• Excellent interpersonal communication skills, including conflict resolution, problem-solving, and negotiation.
• Clinical knowledge of multiple age groups, medical illnesses, treatment plans, disease processes, diagnoses, and anticipated lengths of stay.
• Strong organizational and time-management skills, including the ability to multitask and prioritize.
• Ability to work independently and exercise sound judgment when interacting with physicians, payers, patients, and families.
• Ability to communicate with third-party payers to obtain authorization for appropriate treatment settings for patients requiring medical, psychiatric, or chemical-dependency treatment.
• Ability to complete required competencies during orientation and maintain annual departmental competency requirements.
• Ability to collaborate effectively across social, economic, and cultural backgrounds.
• Computer skills, including Microsoft Office applications: Excel, Word, PowerPoint, and Access.

Nice To Haves

• Three or more years of nursing experience in an emergency department and/or case management, care coordination, or transition of care.
• Previous pediatric experience and/or management experience; charge nurse experience is also acceptable.
• Master's degree in nursing from an accredited university.
• Certification in Case Management.
• Experience coordinating care for medically complex patients, including those with gastrointestinal conditions and in gastroenterology specialty practices.
• Experience navigating managed care, chronic disease management, multidisciplinary care models, and community resources.
• Knowledge of CCS/Medi-Cal regulations and requirements.
• Knowledge of third-party payer requirements to optimize reimbursement.
• Ability to apply pediatric severity-of-illness and intensity-of-service criteria to information extracted from clinical documentation.
• Bilingual ability.
• Certified Pediatric Nurse (CPN).
• Certified Case Manager (CCM).
• Commission for Case Manager Certification (CCMC) credential.
• Pediatric Advanced Life Support (PALS) certification.

Responsibilities

• Deliver care coordination services for patients in a clinic setting.
• Plan and deliver family-centered patient care collaboratively with patients, families, nurses, social workers, physicians, other practitioners, caregivers, and the community.
• Communicate effectively in writing and verbally, and facilitate care along the continuum.
• Advocate for patients and assist them in achieving optimal health, accessing care, and utilizing appropriate resources.
• Provide nursing services and help meet the comprehensive care needs of patients and their families.
• Collaborate in a multidisciplinary setting to provide comprehensive care to eligible CCS-paneled patients.
• Support care planning, problem-solving, care coordination best practices, seamless transitions, and quality patient outcomes.
• Engage patients, families, providers, payers, community agencies, and interdisciplinary team members.
• Communicate with third-party payers to obtain authorization for appropriate treatment settings.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level