RN Discharge Planner - CalAIM

Wellpath • Merced, CA

8h

About The Position

The RN Discharge Planner coordinates daily clinical care, utilization management, and care management activities while ensuring compliance with nursing standards and regulatory requirements. The role provides clinical oversight of discharge planning for CalAIM-eligible individuals, reviewing and approving reentry care plans to ensure they are clinically appropriate and aligned with Enhanced Care Management and Community Supports. The position conducts assessments, leads care coordination with managed care plans and community providers, and supports continuity of care. As the accountable clinician for discharge planning, the RN Discharge Planner helps facilitate safe and effective transitions of care. This position is available only to individuals who reside in the United States.

Requirements

• Unrestricted, current RN license in the state of employment.
• Two years of clinical experience with discharge coordination experience.
• Must maintain all certifications, educational requirements, licensing, and other requirements for the RN license.
• Must reside in the United States.

Nice To Haves

• BSN.
• CCM.
• Previous correctional or detention facility experience.

Responsibilities

• Coordinate clinical reviews, utilization management activities, and application of established care management criteria.
• Review clinical documentation, referrals, and pre-certification requests for compliance with department guidelines and regulatory requirements.
• Collaborate with medical directors, providers, site personnel, and care management teams to support patient care, discharge planning, and continuity of care.
• Monitor utilization data, claims reviews, and referral activity to ensure accuracy, appropriate coding, and effective cost management.
• Provide clinical oversight of reentry care plans and coordinate with managed care plans, community providers, and CalAIM partners to support successful care transitions.

Benefits

• Medical, dental, and vision benefits.
• Paid time off.
• 401(k).
• DailyPay.
• Tuition assistance and dependent scholarships.
• Employee Assistance Program, including free counseling and health coaching.
• Company-paid life insurance.
• Tax-free Health Spending Accounts (HSA).
• Wellness program featuring fitness memberships and product discounts.
• Preferred banking partnership and discounted rates for home and auto loans.
• Ongoing training and development opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed