RN Care Manager: Hospital Care Coordination & Transitions

Mlk-Community-Healthcare-; California; On-site; USD 90,000 - 120,000; Full time

Job summary

MLK Community Healthcare seeks a Case Manager to support physicians and the interdisciplinary team in coordinating patient care across the hospitalization stay. You will assess needs, promote efficient utilization, and facilitate discharge planning while ensuring timely payer communications and compliance with regulatory requirements.

The role emphasizes collaboration, documentation accuracy, and patient-centered care to improve outcomes and satisfaction while managing costs.

Qualifications

• Bachelor of Science degree in nursing preferred.
• Minimum of one (1) to three (3) years of hospital or related experience required.
• Internals with at least 18 months acute care case management/coordination experience will be considered in lieu of nursing clinical experience.
• Able to navigate and connect successfully with outside provider networks (Health Plans, IPA’s, and FQHC’s).
• Bilingual language skills preferred (Spanish)
• Basic computer skills
• Current Basic Life Support (BLS)
• Certification in Case Management preferred.
• ED Care Managers: Must complete annual Workplace Violence Prevention Program/Certificate, per hospital policy, during initial training/orientation but not to exceed 90 days from hire/transfer.

Responsibilities

• Assess patient care needs and psychosocial status and develop intervention plans.
• Coordinate discharge planning and transfers to appropriate settings.
• Collaborate with physicians and the interdisciplinary team to ensure timely care progression and efficient utilization.
• Document and communicate medical necessity and payer requirements to support billing and reimbursement.
• Maintain active communication with Patient Financial Services and HIM as needed.

Skills

Case management

Nursing RN

Care coordination

Communication

Education

Bachelor of Science degree in nursing

Job description

MLK Community Healthcare seeks a Case Manager to support physicians and the interdisciplinary team in coordinating patient care across the hospitalization stay. You will assess needs, promote efficient utilization, and facilitate discharge planning while ensuring timely payer communications and compliance with regulatory requirements.

The role emphasizes collaboration, documentation accuracy, and patient-centered care to improve outcomes and satisfaction while managing costs.