RN Discharge Planner - CalAIM

Wellpath; Napa (CA); On-site; USD 85,000 - 115,000; Full time

Benefits offered by this job

DailyPay

Tuition Assistance

EAP & Counseling

Life Insurance

HSA

Wellness Program

Banking Discounts

Job summary

Wellpath is seeking an RN Discharge Planner to coordinate daily clinical care, utilization management, and care coordination for CalAIM-eligible individuals. The role focuses on ensuring clinically appropriate discharge plans, collaboration with care teams, and seamless transitions of care.

The ideal candidate has an unrestricted RN license, 2 years of discharge coordination experience, and comfort working in a facility setting. Training and development opportunities are provided.

Qualifications

• RN license in state of employment (unrestricted)
• BSN degree preferred; CCM certification encouraged
• Two years’ discharge coordination experience; prior correctional/detention facility exposure is a plus

Responsibilities

• Coordinate daily clinical reviews, utilization management, and care management per established criteria
• Review clinical documents, referrals, and pre-certification requests for compliance
• Collaborate with medical directors, providers, site personnel, and care teams to support discharge planning and continuity of care
• Monitor utilization data, claims and referrals to ensure accurate coding and cost management
• Oversee reentry care plans and coordinate with managed care plans and community partners for safe transitions

Skills

Discharge planning

Care coordination

Utilization management

Team collaboration

Education

RN license

BSN preferred

CCM preferred

Tools

EMR systems

CMS/CalAIM knowledge

Job description

• Make a difference every day in the lives of the underserved
• Join a mission driven organization with a people first culture
• Excellent career growth opportunities
  

• Make a difference every day in the lives of the underserved
• Join a mission driven organization with a people first culture
• Excellent career growth opportunities
  

Join Us And Find a Career That Supports

• Caring for overlooked, underserved, and vulnerable patients
• Autonomy in a warm team environment
• Growth and training
  

Perks And Benefits

In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:

• DailyPay, receive your money as you earn it!
• Tuition Assistance and dependent Scholarships
• Employee Assistance Program (EAP) including free counseling and health coaching
• Company paid life insurance
• Tax free Health Spending Accounts (HSA)
• Wellness program featuring fitness memberships and product discounts
• Preferred banking partnership and discounted rates for home and auto loans
  

Why Us

Now is your moment to make a difference in the lives of the underserved.

For those whose calling it is to serve others, now is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and innovation, to live our mantra to “Always Do The Right Thing!”, and to collectively do our part to heal the world, one patient at a time.

Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan.

We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support.

How you make a difference

The RN Discharge Planner H coordinates daily clinical care, utilization management, and care management activities while ensuring compliance with nursing standards and regulatory requirements. This role provides clinical oversight of the discharge planning process for CalAIM-eligible individuals, reviewing and approving reentry care plans to ensure they are clinically appropriate and aligned with Enhanced Care Management and Community Supports. The position conducts assessments, leads care coordination with managed care plans and community providers, and supports continuity of care. As the accountable clinician for discharge planning, this role helps facilitate safe and effective transitions of care.

Key Responsibilities

• Coordinate clinical reviews, utilization management activities, and application of established care management criteria.
• Review clinical documentation, referrals, and pre-certification requests to ensure compliance with department guidelines and regulatory requirements.
• Collaborate with medical directors, providers, site personnel, and care management teams to support patient care, discharge planning, and continuity of care.
• Monitor utilization data, claims reviews, and referral activity to ensure accuracy, appropriate coding, and effective cost management.
• Provide clinical oversight of reentry care plans and coordinate with managed care plans, community providers, and CalAIM partners to support successful care transitions.

Qualifications & Requirements

Education

• Unrestricted, current RN license in state of employment
• BSN, CCM preferred.

Experience

• Two (2) years’ clinical experience with Discharge Coordination experience
• Previous correctional/detention facility experience

Licenses/Certifications

• Must maintain all certifications, educational requirements, licensing, etc. for RN license

This position is available only to those who reside in the United States.

We are an Equal Employment Opportunity Employer

We value the contributions of team members with a broad range of experiences, skills, and perspectives and are committed to providing equal employment opportunity for all.

Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description.