Case Manager Utilization RN - Pipeline Variable Shifts and Schedules

Kaiser Permanente; Riverside (CA); On-site; USD 95,000 - 116,000; Full time

Job summary

Kaiser Permanente in Riverside, CA is seeking a Case Manager Utilization RN to coordinate admissions, ensure appropriate care levels, and develop safe discharge plans. You will collaborate with physicians and the multidisciplinary team to optimize patient care and transitions.

This full-time role emphasizes patient advocacy, utilization management, and timely review of hospital stays to meet patient needs within regulatory guidelines.

Qualifications

• Active RN license required in California.
• Experience in case management preferred.
• Strong collaboration with physicians and care teams.

Responsibilities

• Plan, develop, assess and evaluate care for members.
• Collaborate with physicians and the health care team to develop plans.
• Recommend alternative levels of care and ensure regulatory compliance.
• Assess high‑risk patients needing post‑hospital planning.
• Develop and coordinate discharge plans.
• Communicate plans to physicians, patients, families, and agencies.
• Review and coordinate hospital stays for timely service delivery.
• Participate in Bed Huddles and implement recommendations.
• Coordinate continuity of care, including utilization management.
• Conduct daily clinical reviews for utilization/quality management.

Skills

Case management

Multidisciplinary teamwork

Patient advocacy

Communication

Education

RN License

Job description

The Case Manager Utilization RN works collaboratively with physicians to coordinate patient admissions and continued stays, ensuring appropriate care levels and safe discharge plans. This role is ideal for those who thrive in a fast-paced environment and are skilled in patient advocacy and multidisciplinary teamwork.

Highlights

• Pay: $69 - $84/hour


• Location: Riverside, CA


• Schedule: Full Time

What You'll Do

• Plan, develop, assess and evaluate care provided to members.


• Collaborate with physicians and the multidisciplinary health care team to develop individualized plans of care.


• Recommend alternative levels of care and ensure compliance with regulations.


• Assess high-risk patients in need of post-hospital care planning.


• Develop and coordinate discharge plans to meet patient needs.


• Communicate plans to physicians, patients, families, and community agencies.


• Review and coordinate patients' hospital stays to ensure timely service delivery.


• Participate in Bed Huddles and implement recommendations.


• Coordinate continuity of care, including utilization management and discharge planning.


• Conduct daily clinical reviews for utilization/quality management activities.

Requirements

• Education: RN License required


• Experience: Experience in case management preferred


• Licenses & Certifications: Current RN License in California

About Kaiser Permanente

Kaiser Permanente is a leading healthcare provider committed to delivering exceptional patient care. They focus on improving health outcomes through a collaborative approach and innovative solutions in healthcare delivery.