Registered Nurse - Case Manager

Talencia; Torrance (CA); On-site; Full time

Job summary

A leading healthcare provider is seeking a Registered Nurse Case Manager in Torrance, California. This vital role focuses on care coordination, discharge planning, and supporting diverse patients across various age groups. The ideal candidate will possess strong acute care management skills, with experience in interdisciplinary collaboration and a solid understanding of Medicare guidelines.

Qualifications

• 2+ years of recent acute care case management and discharge planning experience.
• Proficiency in InterQual criteria and knowledge of Medicare guidelines preferred.
• Experience with Behavioral Health or Utilization Review is a plus.

Responsibilities

• Conduct patient assessments and care coordination.
• Develop and implement patient-centered treatment plans.
• Coordinate services across multiple disciplines.

Skills

Communication

Organizational Skills

Independent Working

Education

Active RN license in California

Tools

Epic EHR

Job description

Pay Rate : $70 / hr (W2) $74 / hr (1099)

Job Summary :

This is a travel position focused on providing high-quality care coordination and discharge planning services for a diverse patient population. The ideal candidate is a skilled RN with a strong background in acute medical care management and a solid understanding of Medicare guidelines InterQual criteria and interdisciplinary collaboration.

Key Responsibilities :

Conduct patient assessments care coordination and discharge planning

Utilize InterQual criteria to determine medical necessity and level of care

Develop and implement patient-centered treatment and transition plans

Coordinate services across multiple disciplines including DME SNF home health and ambulance transport

Address complex social determinants of health including homelessness substance abuse and mental health crises

Participate in interdisciplinary team meetings and organize family conferences

Handle prior authorizations and communicate with HMOs IPAs Medicare Medi-Cal and other payers

Maintain compliance with CMS DRG HIPAA and other regulatory guidelines

Support patients across all age groups : neonates pediatrics adults and geriatrics

Provide weekend coverage (monitor up to 2 units) focusing on timely and safe discharges

Required Qualifications :

Active RN license in California

Minimum 2 years of recent acute care case management and discharge planning experience

Experience using Epic EHR

Knowledge of Medicare and Medi-Cal guidelines

Ability to work independently and manage a caseload of up to 25 patients

Strong communication and organizational skills

Preferred Experience :

Familiarity with behavioral health foster care adoption services and protective services

Proficiency in InterQual criteria (preferred)

Experience with appeals / denials workers compensation and utilization review

Knowledge of advance directives POLST forms and end-of-life care planning

Teaching and community hospital experience (a plus)

Work Setting & Support :

Interdisciplinary support from IV Therapy PT RT Pharmacy Social Services Radiology etc.

Key Skills

Employment Type : Full Time

Experience : years

Vacancy : 1

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Registered Nurse Case Manager • Torrance, California, USA