RN - Case Manager

Cynet Health; Redlands (CA); On-site; USD 96,000 - 131,000; Full time

Job summary

Cynet Health is seeking an RN Case Manager to focus on emergency department case management within a 13‑week assignment. The role requires a California RN license, BLS, MAB credentials, and experience in acute care and utilization management. Night shift with 10‑hour blocks, travel may be involved.

Minimum 3 years’ experience; 5 preferred. Must be comfortable with admission criteria, care coordination, discharge planning, and concurrent reviews.

Qualifications

• Acute care experience required.
• Admission criteria knowledge.
• Care coordination skills.
• Concurrent review expertise.
• Ability to determine medical necessity per Evidence-Based Guidelines.
• Discharge planning experience.
• Needs assessment and DME capabilities.
• Plan of Care development.
• Familiarity with InterQual Criteria.
• Knowledge of HIPAA guidelines.
• Understanding of The Joint Commission/Core Measure/National Safety Goals.

Responsibilities

• Emergency department case management focus with ED services.
• Route tertiary level care including STEMI/NS transfers.
• Pediatric patients referred out; unit does not handle trauma or burn cases.

Skills

Acute care

Admission criteria

Care coordination

Concurrent review

Medical necessity

Discharge planning

Needs assessment

Plan of care

InterQual familiarity

HIPAA knowledge

Joint Commission knowledge

Job description

RN - Case Manager

Profession: Registered Nurse

Specialty: Utilization Management

Duration: 13 weeks

Shift: Night

Hours per Shift: 10 hours

Experience: Minimum 3 years required, 5 preferred

License: Valid CA License required

Certifications: BLS, MAB

Must-Have:

• Acute Client experience
• Admission Criteria knowledge
• Care coordination skills
• Concurrent Review expertise
• Ability to determine Medical Necessity per Evidence-Based Guidelines
• Discharge Planning experience
• Needs Assessment and Order DME capabilities
• Plan of Care development
• Familiarity with InterQual Criteria
• Knowledge of HIPAA guidelines
• Understanding of The Joint Commission/Core Measure/National Safety Goals

Description:This position is for a Case Manager.The focus is on the emergency department with a variety of services offered.Pediatric patients and infants are referred out.Tertiary level care cases, including STEMI and NS transfers, will be routed accordingly.The unit does not handle trauma cases or burn patients.The average daily census is 15 patients, with 22 rooms and 34 beds.A minimum of 3 years of experience is required, with 5 years preferred.Seasoned travelers are preferred, but first-timers with substantial experience are welcome.Every other weekend is required.Navy blue scrubs are required and not provided.