Rn Jobs in Los Angeles, TX

About The Position

Requirements

• Associate Degree in Nursing (ADN) from an accredited school of nursing; a higher degree is accepted.
• At least 2 years of clinical nursing experience; acute care, ambulatory, or case management experience is preferred.
• Current unrestricted RN license to practice nursing in the State of Texas, or a compact state license, required upon hire.
• Basic Life Support (BLS) certification through an approved American Heart Association Training Network, required upon hire.
• Valid driver's license, required upon hire.
• Knowledge of nursing practice and documentation requirements.
• Knowledge of acute and post-acute care settings, medical necessity, utilization review concepts, and documentation standards.
• Ability to work with medical and nursing staff to establish and maintain clinical and operational standards of practice.
• Ability to collaborate effectively with patients and internal and external service providers.
• Knowledge of electronic health record systems and clinical documentation workflows.
• Ability to deliver high-quality customer service through telephone, electronic, and in-person communication.
• Strong problem-solving skills, attention to detail, and accuracy.
• Strong assessment, critical-thinking, and decision-making skills.
• Knowledge of complex medical conditions and comorbidities.
• Ability to apply independent nursing judgment in referral reviews, medical-necessity assessment, and appropriateness determinations.
• Ability to work effectively in a complex, dynamic environment with multidisciplinary, cross-functional, and matrixed teams.
• Knowledge of social determinants of health and cultural humility and sensitivity when working with underserved patient populations.
• Skill in triaging patients and ensuring an appropriate level of care.
• Ability to maintain professionalism, confidentiality, and ethical standards.

Nice To Haves

• At least 1 year of experience with referral review and coordination.
• At least 1 year of experience determining medical necessity.
• At least 1 year of experience with Epic EHR.

Responsibilities

• Conduct clinical reviews of incoming referrals to confirm documentation is complete and accurate for program admission.
• Review eligibility requirements, including required health coverage, and assess referrals against established clinical and program criteria.
• Recommend the most appropriate level or program of care within established parameters and escalate complex, high-risk, or unclear referrals to the appropriate provider.
• Manage referral workflows, prioritization, and throughput to support timely decision-making and placement.
• Provide clear referral status updates to internal teams, providers, and external partners.
• Use nursing knowledge and clinical judgment to assess referral urgency and complexity.
• Review medical records to identify the most appropriate care transition setting.
• Collaborate with inpatient care teams, case management, and providers to clarify referral needs and clinical documentation.
• Meet with patients in person to discuss individual needs, explain program offerings and admission requirements, and assess appropriateness and interest.
• Serve as a clinical liaison among providers, hospital case management teams, post-acute care facilities, and other external partners.
• Track referral progress and follow up proactively to support continuity of care and avoid unnecessary delays.
• Provide recommendations to leadership on referral criteria, workflow, clinical appropriateness, access barriers, and program capacity.
• Identify trends in referral patterns, clinical complexity, placement barriers, and outcomes, and recommend process improvements.
• Coordinate with program teams regarding clinical acceptance, patient intake, and placement into Medical Respite, shelter, transitional housing, or permanent housing.
• Attend staff meetings, huddles, and education offerings to maintain role competency and department alignment.
• Support organizational and departmental initiatives that promote a collaborative and positive workplace culture.
• Maintain accurate, timely, and appropriate documentation of referral reviews, determinations, and care coordination in the electronic health record.
• Adhere to HIPAA, organizational policies, and regulatory standards.
• Maintain awareness of department performance indicators, metrics, and quality measures.
• Perform other duties as assigned.