RN Care Manager — Health Plan & Care Coordination

Adventist Health; Lincoln (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Adventist Health Roseville in California is seeking a Registered Nurse (RN) with preferred BSN and CCM eligibility to lead and evaluate cavitation care management service lines. The role focuses on whole-person care, inpatient and outpatient coordination, and cost-effective care planning within a faith-based, nonprofit health system.

The position emphasizes collaboration with physicians, care teams, and analytics to optimize patient flow, quality, and discharge planning while adhering to medical

Qualifications

• Bachelor's Degree in Nursing (BSN) preferred.
• Nursing experience preferred.
• Certified Case Manager (CCM) preferred.
• Registered Nurse (RN) licensure required.

Responsibilities

• Partner with internal and external physician advisors, claims, data management and analytics to safeguard member population outcomes.
• Collaborate with physicians, staff and service line leadership on quality and performance improvement for resource utilization and cost-effective care.
• Ensure medical necessity criteria are met and communicate discharge plan changes as needed.
• Coordinate discharge planning and utilization management with staff to support medical necessity.
• Perform other job-related duties as assigned.

Skills

Nursing experience

Communication skills

Education

BSN preferred

Job description

Adventist Health Roseville in California is seeking a Registered Nurse (RN) with preferred BSN and CCM eligibility to lead and evaluate cavitation care management service lines. The role focuses on whole-person care, inpatient and outpatient coordination, and cost-effective care planning within a faith-based, nonprofit health system.

The position emphasizes collaboration with physicians, care teams, and analytics to optimize patient flow, quality, and discharge planning while adhering to medical