<span>Case Manager Utilization RN, Per Diem Day</span>

$148,762 - $182,042/Yr

Kaiser Permanente - Fontana, CA

Full-time - Entry Level

Fontana, CA

Ambulatory Health Care Services

About the position

The Case Manager Utilization RN is responsible for coordinating patient care in collaboration with physicians and multidisciplinary teams. This role involves assessing patient needs, developing discharge plans, and ensuring compliance with healthcare regulations. The RN will advocate for patients, manage resources effectively, and facilitate transitions to appropriate care settings while maintaining high-quality standards.

Responsibilities

• Plans, develops, assesses and evaluates care provided to members.
• Collaborates with physicians and the multidisciplinary healthcare team to develop individualized plans of care.
• Recommends alternative levels of care and ensures compliance with healthcare regulations.
• Assesses high-risk patients for post-hospital care planning.
• Develops and coordinates discharge plans to meet patient needs and communicates them effectively.
• Reviews and monitors patient hospital stays to ensure timely delivery of essential services.
• Participates in Bed Huddles and implements recommendations based on patient needs.
• Coordinates continuity of care, including utilization management and discharge planning.
• Conducts daily clinical reviews for utilization and quality management activities.
• Acts as a liaison between inpatient facilities and referral agencies, providing case management to patients.
• Refers patients to community resources for post-hospital needs and coordinates transfers to appropriate facilities.
• Educates healthcare team members on discharge planning processes and resource utilization.
• Provides patient education to assist with discharge and coping with health issues.
• Reports unusual occurrences related to quality and patient safety during case reviews.
• Analyzes utilization patterns and participates in data collection for monitoring activities.
• Facilitates care planning rounds and patient family conferences as needed.

Requirements

• Two (2) years combined RN experience in an acute care setting or case management required.
• Completion of an accredited RN training program that allows graduates to take the RN license exam.
• Registered Nurse License (California) required.
• Basic Life Support certification required.
• Demonstrated ability in utilization review/management, discharge planning, or case management.
• Working knowledge of regulatory requirements and accreditation standards.

Nice-to-haves

• Bachelor's degree in nursing or healthcare-related field preferred.
• Acute Case Management or hospital experience preferred.

Benefits

• Competitive hourly pay ranging from $71.52 to $87.52.
• Flexible per diem work schedule with day shifts and rotating weekends.