RN Care Manager: Health Plan & Care Coordination

Adventist Health; Galt (CA); Presencial; USD 90.000 - 120.000; Jornada completa

Descripción de la vacante

Adventist Health in Roseville, CA, seeks a Licensed Registered Nurse for a role managing development, implementation, and evaluation of cavitation care management service lines. Focus on continuity of care, cost effectiveness, whole-person care, and care planning within hospital and outpatient settings.

The position requires RN licensure in the state of practice with preferred BSN and CCM certification. Collaboration with physicians and departments to improve utilization and patient flow is

Formación

• BSN preferred.
• Nursing experience preferred.
• Certified Case Manager (CCM) preferred.
• RN licensure in the state of practice required.

Responsabilidades

• Partners with physicians, claims, data management and analytics to support member care.
• Collaborates on quality and performance improvement to optimize resource use and care delivery.
• Ensures medical necessity criteria are met and communicates discharge plan changes.
• Manages discharge planning and utilization management communications.
• Performs other job-related duties as assigned.

Conocimientos

Case management

Care coordination

Utilization review

Educación

BSN

Nursing experience

Descripción del empleo

Adventist Health in Roseville, CA, seeks a Licensed Registered Nurse for a role managing development, implementation, and evaluation of cavitation care management service lines. Focus on continuity of care, cost effectiveness, whole-person care, and care planning within hospital and outpatient settings.

The position requires RN licensure in the state of practice with preferred BSN and CCM certification. Collaboration with physicians and departments to improve utilization and patient flow is