Remote Care Manager RN: Case & Utilization Expert

Agence PROvidence; Santa Rosa (CA); On-site; USD 95,000 - 147,000; Part time

Job summary

Providence caregivers at Santa Rosa Memorial Hospital seek a part-time Case Management RN. You will manage patient care during admission, coordinate with medical staff to ensure optimal resource use, and monitor records against clinical and financial standards.

Strong communication and risk-management skills are essential to minimize liability and support reimbursement reviews. Required is a California RN license with acute nursing/Case Management experience; a BSN within 3 years and CCM

Qualifications

• California Registered Nurse license required.
• 2 years of acute nursing experience or case management experience.
• Case management experience preferred.

Responsibilities

• Manage specific patients throughout admission to ensure resource availability.
• Communicate daily with medical staff and center personnel for appropriate utilization.
• Monitor medical records for variances to clinical/financial standards and intervene.
• Apply risk management and infection control knowledge to support patient outcomes.
• Identify issues exposing the organization to liability and assist management to mitigate risk.
• Provide payor/utilization review with concurrent retrospective review for reimbursement.

Skills

Nursing

Case management

Communication

Education

California RN License

BSN within 3 years

CCM certification

Job description

Providence caregivers at Santa Rosa Memorial Hospital seek a part-time Case Management RN. You will manage patient care during admission, coordinate with medical staff to ensure optimal resource use, and monitor records against clinical and financial standards.

Strong communication and risk-management skills are essential to minimize liability and support reimbursement reviews. Required is a California RN license with acute nursing/Case Management experience; a BSN within 3 years and CCM