RN Case Manager II, Care Coordination, Per Diem, Days

Marin General Hospital dba MarinHealth Medical Center; United States; On-site; USD 70,000 - 90,000; Full time

Job summary

Marin General Hospital dba MarinHealth Medical Center is looking for a dedicated RN Case Manager to lead interdisciplinary care planning. You will work closely with healthcare teams to develop, implement, and manage patient care plans, ensuring timely discharge and effective resource use.

This position requires strong clinical assessment skills and at least three years of experience in an acute care setting, with a nursing degree preferred. Join us in providing high-quality care with a personal touch.

Qualifications

• Three or more years in an acute patient care setting, preferably in medical/surgical or critical care.
• Substantial recent experience in utilization review and/or discharge planning in an acute care setting strongly preferred.
• Ability to work independently with minimal direction, anticipating and organizing workflow.

Responsibilities

• Coordinate the plan of care with the healthcare team.
• Complete initial assessments within 24 hours of admission.
• Collaborate with physicians to expedite discharge plans.

Skills

Effective communication skills

Clinical assessment skills

Problem-solving skills

Education

Bachelor of Science degree in Nursing

Tools

Electronic Health Record

Job description

About MarinHealth

Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. With a world‑class physician and clinical team, an affiliation with UCSF Health, an ever‑expanding network of clinics, and a new state‑of‑the‑art hospital, MarinHealth is growing quickly. MarinHealth comprises MarinHealth Medical Center, a 327‑bed hospital in Greenbrae, and 55 primary care and specialty clinics in Marin, Sonoma, and Napa Counties.

We attract healthcare’s most talented trailblazers who appreciate having the best of both worlds: the pioneering medicine of an academic medical center combined with an independent hospital’s personalized, caring touch. MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being named one of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5‑star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parents.

Job Description Summary

The RN Case Manager, in collaboration with members of the healthcare team, leads the development and implementation of the interdisciplinary plan of care for patients, determining the appropriate level of care, supervising the provision of the discharge plan of care, and ensuring effective quality and cost‑efficient outcomes. This position functions as the key linkage between the physician, staff, and hospital leadership in the day‑to‑day management of appropriate and efficient patient care and functions as an advisor to the physician with accountability to escalate cases to the Medical Director (as necessary) to ensure the provision of appropriate and effective patient care.

Responsibilities

• Care Coordination
  • Work with the healthcare team to expedite the plan of care and correct barriers to efficient throughput.
  • Create a plan of care outlining key interventions and outcomes for each inpatient day.
  • Actively lead multidisciplinary case conferences and develop comprehensive, cost‑effective case management plans.
  • Make independent assessments and recommendations regarding course of action in complex situations.
  • Identify and refer quality and risk management concerns to appropriate levels for corrective action and trending.
  • Proactively solicit physician orders for services.
• Utilization and Resource Management
  • Identify target Length of Stay (LOS) by assigning a working DRG in MIDAS within 24 hours of admission.
  • Complete admission reviews using standardized criteria within 24 hours and document findings.
  • Escalate to the Medical Director when criteria are not met or the attending physician disagrees.
  • Complete continued‑stay reviews to ensure appropriate care level.
  • Monitor LOS relative to MS‑DRG/GMLOS for all patients.
  • Complete concurrent reviews for specified health plans with documentation to avoid payor denials.
  • Ensure timely transition to the next level of care and collaborate with physicians and CDI to keep the medical record accurate.
  • Work with physicians to determine appropriate post‑hospital care and community resources.
  • Communicate with third‑party payers, manage authorizations, and handle denials and appeals.
  • Identify avoidable days, intervene to correct delays, and enter outcomes in MIDAS.
  • Initiate reviews of inappropriate utilization and follow‑through to resolution.
• Discharge Planning / Initial Assessment / Development / Evaluation
  • Complete initial assessment within 24 hours of admission and document findings.
  • Gather medical, psychosocial, and financial data from assessments, families, physicians, and other providers.
  • Determine risk level and client service needs.
  • Formulate a discharge plan after a face‑to‑face interview and discuss available options with all stakeholders.
  • Collaborate with physicians to expedite resolution of issues that affect the discharge plan.
  • Identify potential problems, prevent and resolve variances, and handle conflict with patients, families, and team members.
  • Implement the discharge plan and intervene when difficulties arise, coordinating with other staff.
  • Mobilize resources to accelerate patient movement and meet discharge timeliness indicators.
  • Identify and leverage patient and family strengths for optimal use of resources.
  • Secure required post‑discharge services, negotiate coverage, obtain authorizations, and respect regulatory guidelines.
  • Coordinate with social work on discharge planning issues and address barriers promptly.
• Department Operations and Development
  • Actively participate in meetings, process development, training, disease and population management strategies, and goal setting.
  • Ensure applicable department and regulatory targets for productivity and performance are met.
  • Comply with reporting requirements for risk management and medical/legal situations.
  • Contribute to a care delivery system sensitive to individual needs, promoting effective resource utilization.
  • Support team decision‑making and collaborate on interdependent tasks.
  • Prepare and conduct presentations for multidisciplinary teams and special projects.
  • Adhere to department and facility policies and support initiatives.
  • Maintain accurate, current, and legible patient records using approved forms and formats.
• Secondary Responsibilities
  • Participate in interviews for Case Managers and Department Assistants, recommend applicants, and provide necessary training.
  • Attend and participate in community‑based committees and task forces as schedules permit.
• Other Duties as Assigned

Qualifications

• Education
  • Bachelor of Science degree in Nursing preferred.
• Experience
  • Three (3) or more years in an acute patient care setting, preferably in medical/surgical or critical care.
  • Substantial recent experience in utilization review and/or discharge planning in an acute care setting strongly preferred.
  • Broad clinical background strongly preferred.
  • Demonstrated effective functional supervision and leadership skills preferred.
• Licenses & Certifications
  • Registered Nurse (RN) required at hire.
  • Basic Life Support (BLS) required at hire.
  • Integrative Agitation Management (IAMTAC) required within 30 days of hire.
• Prerequisite Skills
  • Ability to read, write, and follow English verbal and written instructions.
  • Excellent oral and written communication, interpersonal, problem‑solving, conflict resolution, presentation, time management, positive personal influence, and negotiation skills.
  • Leadership skills to delegate, functionally supervise, provide guidance, and hold others accountable.
  • Ability to work independently with minimal direction, anticipate and organize workflow, prioritize, and follow through.
  • Strong clinical assessment and critical thinking skills for utilization review and discharge planning with complex patients.
  • Strong attention to detail and accuracy.
  • Ability to work in a high volume caseload environment and manage rapidly changing priorities.
  • Demonstrated constructive collaboration with a broad spectrum of health care professionals.
  • Assertive and creative problem‑solving, system planning, and management.
  • Basic computer skills, including use of Electronic Health Record.

Equal Employment Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sexual orientation, gender identity, protected veteran status or disability status, and any other classifications protected by federal, state, and local laws.