RN Case Manager: Sign-On Bonus & Care Coordination Pro

Southern California Hospitals; Culver City (CA); On-site; USD 125,000 - 180,000; Full time

Benefits offered by this job

Sign-on bonus $25,000

Job summary

Alta Hospital is seeking an RN Case Manager to assess inpatients for utilization review, plan safe discharges, and coordinate care with the interdisciplinary team. The role emphasizes patient advocacy, timely reviews, and cost-effective care within regulatory guidelines.

The successful candidate will have CA RN licensure, case management or nursing leadership experience, strong communication skills, and familiarity with CMS/Medicare and care coordination processes.

Qualifications

• Current CA RN license and active practice.
• Knowledge of patient throughput, care coordination, and discharge planning.
• Experience in utilization review and medical necessity evaluation.
• Proficient in EMR systems and relevant CMS/Medicare rules.

Responsibilities

• Collaborates with patient/family and team to optimize outcomes and plan transfers.
• Reviews medical necessity and documents utilization concurrently for payers.
• Leads discharge planning assessments and updates in the medical record.
• Liaises with medical staff to ensure continuity of care and patient choice.
• Participates in patient/family meetings and document informed decisions.
• Contributes data to Utilization Management Committee.

Skills

Case management

Nursing leadership

Care coordination

EMR proficiency

CMS/Medicare knowledge

Communication skills

Interdisciplinary rounds

Education

Registered Nurse license (CA)

BSN (preferred)

CCM (preferred)

Tools

AllScripts Care Management

Milliman Care Guidelines

Interqual

Job description

Alta Hospital is seeking an RN Case Manager to assess inpatients for utilization review, plan safe discharges, and coordinate care with the interdisciplinary team. The role emphasizes patient advocacy, timely reviews, and cost-effective care within regulatory guidelines.

The successful candidate will have CA RN licensure, case management or nursing leadership experience, strong communication skills, and familiarity with CMS/Medicare and care coordination processes.