RN Case Manager — Care Coordination & Discharge Lead

Los Angeles Community Hospitals; Los Angeles (CA); On-site; USD 67,000 - 96,000; Full time

Job summary

Los Angeles Community Hospitals is seeking an RN Case Manager to perform clinical assessment and reassessment of acute inpatients for utilization review and safe discharge planning. The role requires collaboration with the interdisciplinary team to promote safe, cost-effective patient care transitions and to advocate for patient self-determination while maintaining regulatory compliance.

Strong knowledge of CMS/Medi-Cal, EMR proficiency, and the ability to lead rounds are essential; 1 year of

Qualifications

• One year of case management or nursing leadership experience.
• Current RN licensure in California.
• Understanding of patient throughput, care coordination and care planning.
• Ability to assess medical stability for discharge and medical necessity.
• EMR literacy and computer proficiency.
• Knowledge of CMS, Medicare, Medi-Cal and managed care reimbursement.
• Familiarity with Joint Commission, CMS and CDPH requirements.
• Excellent written and verbal English communication.
• Ability to collaborate across the organization and lead rounds.

Responsibilities

• Collaborate with patient and family to optimize outcomes and arrange transitions of care.
• Review medical necessity using approved criteria to determine level of care.
• Coordinate discharge planning and document concurrently in the medical record.
• Communicate with payers and provide needed information for authorization.
• Lead interdisciplinary rounds and liaison with medical staff to ensure continuity.

Skills

Case management experience

Nursing leadership experience

EMR proficiency

Care coordination

Discharge planning

Communication skills

Knowledge of CMS/Medicare/Medi-Cal

Interdisciplinary rounds

Education

Bachelor of Science in Nursing

Certified Case Manager (CCM)

Tools

AllScripts Care Management

Milliman Care Guidelines

Job description

Los Angeles Community Hospitals is seeking an RN Case Manager to perform clinical assessment and reassessment of acute inpatients for utilization review and safe discharge planning. The role requires collaboration with the interdisciplinary team to promote safe, cost-effective patient care transitions and to advocate for patient self-determination while maintaining regulatory compliance.

Strong knowledge of CMS/Medi-Cal, EMR proficiency, and the ability to lead rounds are essential; 1 year of