RN Case Manager, Part time, 11:30am-8pm (Internal Candidates Only)

RiseMe; Whittier (CA); On-site; USD 90,000 - 110,000; Full time

Job summary

PIH Health is seeking an RN Case Manager to coordinate care and partner with nursing, physicians and other disciplines to pace care and achieve outcomes. The role emphasizes discharge planning, care level determination, and ensuring smooth transitions across care settings.

The RN Case Manager will conduct utilization review using criteria to support medical necessity and optimize hospital resources, contributing to high-quality patient experiences.

Responsibilities

• Coordinate care with nursing, physicians and other disciplines to pace care and achieve outcomes.
• Perform discharge planning and determine level of care needs across settings.
• Conduct utilization review to support medical necessity and optimize hospital resources.

Skills

Nursing

Case management

Education

RN license

Job description

The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace the care for outcomes while meeting core measures within the appropriate level of care. The RN Case Manager provides discharge planning by collaboratively determining level of care needs beyond acute care, providing decision support to patients and families and physicians, managing patient and family expectations and ensuring a smooth transition to the next level of care and services. The RN Case Manager performs utilization review with a high level of expertise by using criteria that demonstrates medical necessity to achieve reimbursement for services and ensuring appropriate utilization of hospital resources.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.