RN Case Manager

Precision Scans•Eureka, CA

22h•$60 - $65

About The Position

The Registered Nurse Case Manager is responsible for coordinating patient care, ensuring appropriate utilization of services, developing care plans, and facilitating communication among patients, families, providers, and interdisciplinary teams. The RN Case Manager promotes quality, cost-effective outcomes while maintaining compliance with organizational policies and regulatory requirements.

Requirements

Current and valid Registered Nurse (RN) license .
Associate or Bachelor’s degree in Nursing (BSN preferred).
Minimum 1–3 years of clinical nursing experience , preferably in acute care, case management, or utilization review.
Strong clinical assessment and critical-thinking skills.
Excellent communication and interpersonal abilities.
Knowledge of insurance guidelines, discharge planning, and community resources.
Experience with EMR systems (EPIC, Cerner, etc.).
Ability to work independently and manage multiple cases simultaneously.
Must have acute care experience

Responsibilities

Care Coordination & Case Management Conduct comprehensive assessments of patients’ medical, psychosocial, and discharge needs.
Develop, implement, and monitor individualized care plans.
Coordinate services across the continuum of care including admission, treatment, and discharge planning.
Collaborate with physicians, nurses, social workers, and ancillary departments to ensure optimal patient outcomes.
Patient Advocacy Ensure patients and families understand diagnoses, treatment options, discharge plans, and community resources.
Advocate for patient rights, safety, and care preferences.
Utilization Review & Compliance Evaluate medical documentation to ensure appropriate level of care and utilization of resources.
Monitor length of stay and ensure compliance with insurance and regulatory guidelines.
Communicate with insurance providers regarding authorizations and continued stay reviews.
Documentation & Reporting Maintain accurate, timely, and thorough documentation in EMR systems.
Track patient progress, barriers to care, and interventions.
Prepare reports as required by management.
Interdisciplinary Collaboration Participate in interdisciplinary rounds and case conferences.
Communicate effectively with providers, hospital departments, and external agencies.
Ensure smooth transitions of care to home health, skilled nursing, outpatient services, or community support.
Quality & Performance Improvement Identify gaps in care and contribute to quality improvement initiatives.
Participate in audits, training, and policy development.