RN Case Manager: Elevate Chronic Care & Care Coordination

Riverside Medical Clinic; Riverside (CA); On-site; USD 95,000 - 125,000; Full time

Benefits offered by this job

Challenging and rewarding work

Growth and development opportunities

Competitive compensation

Job summary

Riverside Medical Clinic in Riverside, CA, seeks a Population Health RN Case Manager to coordinate team-based care, partnering with patients, families, and physicians to improve health outcomes.

Under the Director of Utilization Management, the role focuses on chronic conditions, complex medical and psychosocial needs, and implements utilization review, discharge planning, and transitional case management per NCQA and policy guidelines.

Qualifications

• Current licensure as a Registered Nurse required.
• Two or more years’ experience in clinical or community health settings preferred.
• Care Coordination, Case Management or Home Health experience preferred.
• Strong clinical assessment and critical thinking skills for complex patients.

Responsibilities

• Provide a coordinated, team-based approach to managing chronically ill patients.
• Stratify patients by risk to determine visit frequency and CCM encounters.
• Collaborate with leaders to implement internal tracking systems for patient panels and AWV follow-ups.
• Ensure documentation for CCM and AWV component billing is complete.
• Empanel patients by provider to balance supply and demand for care needs
• Maintain internal tracking for results, medications, missed appointments, and follow-ups.
• Track AWV scheduling and identify care gaps prior to provider visits.
• Participate in routine huddles to optimize scheduling and care opportunities.
• Provide clinical coaching to motivate self-management and mobilize community resources.
• Develop care plans with mutual goals and monitor adherence and progress.
• Facilitate access to medical and specialty providers as indicated.
• Perform health risk assessments, medication reconciliation, and assess social determinants of health.
• Provide Case Management support for Medicare ACO and HMO members.

Skills

Nursing license

Care coordination

Case management

Clinical assessment

High-volume caseload management

Education

RN license in California

Job description

Riverside Medical Clinic in Riverside, CA, seeks a Population Health RN Case Manager to coordinate team-based care, partnering with patients, families, and physicians to improve health outcomes.

Under the Director of Utilization Management, the role focuses on chronic conditions, complex medical and psychosocial needs, and implements utilization review, discharge planning, and transitional case management per NCQA and policy guidelines.