Care Coordination Nurse: Discharge & Utilization Management

Alameda Health System; Oakland (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Alameda Health System seeks an experienced case management professional to coordinate continuum of care and discharge planning for a defined patient caseload. You will monitor clinical activities, assess care plans, and recommend appropriate levels of care within guidelines.

The role emphasizes collaboration with physicians, nursing, social work, and care management teams to ensure timely discharge and efficient resource utilization.

Qualifications

• Requires active RN license in California.
• BLS certification required; CPI training may be required depending on unit.
• Certification in Case Management (CCMC/ACM) preferred.
• Bilingual skills preferred.

Responsibilities

• Coordinate all utilization review functions including Medicare/Medi-Cal requirements and medical necessity criteria.
• Ensure appropriate level of care and accurate admission status; reference Interqual guidelines as needed.
• Document treatment plans, progress notes and discharge summaries per regulatory standards.
• Develop and coordinate comprehensive discharge plans with patients, families, and care team within 24 hours of admission.
• Collaborate with social work, nursing, and physicians to link patients to post-discharge services.
• Monitor performance targets for department improvements such as readmissions, throughput, and length of stay.

Skills

Care coordination

Care management

Utilization review

Discharge planning

Interdisciplinary teamwork

Education

Associate Degree in Nursing

Bachelor's of Nursing

Master's in Nursing

Job description

Alameda Health System seeks an experienced case management professional to coordinate continuum of care and discharge planning for a defined patient caseload. You will monitor clinical activities, assess care plans, and recommend appropriate levels of care within guidelines.

The role emphasizes collaboration with physicians, nursing, social work, and care management teams to ensure timely discharge and efficient resource utilization.