Senior RN Case Manager: Discharge & Care Coordination

Antelope Valley Medical Center; Lancaster (CA); On-site; USD 100,000 - 165,000; Full time

Job summary

Antelope Valley Medical Center in Lancaster, CA seeks an experienced RN Case Manager to prioritize, plan, and monitor patient progress within the hospital system. You will assess care utilization, promote continuity of care, and guide discharge planning while coordinating with medical staff and payers.

The role requires an RN license, a 2-year degree or higher, and 3+ years of acute care experience. This full-time position offers on-site work with a focus on efficient resource use and patient

Qualifications

• Bachelor’s degree in nursing, preferred
• Minimum 3-years broad-based acute care nursing experience
• Case Management, Discharge Planning, and/or Home Health experience, preferred
• Registered Nurse License
• CPR Certification

Responsibilities

• Identify care levels meeting criteria and recommend alternative, cost-effective services
• Maintain knowledge of Medicare, Medi-Cal, CCS, GHPP, Managed Care rules and limits
• Act as resource for discharge planning and utilization issues
• Facilitate transitions of patients to appropriate level of care
• Coordinate with physicians and payer for authorizations and documentation
• Monitor documentation to support services and ensure accuracy
• Develop and monitor action plans for metrics like length of stay and resource utilization
• Assist with data collection to identify trends and opportunities for improvement
• Provide education to physicians on denied claims and support appeals where needed
• Assist in placement and transfer planning to acute or post-acute facilities

Skills

Case management

Discharge planning

Utilization review

Nursing

Communication skills

Education

Bachelor's degree in nursing

2 Year Degree

Tools

HDM system

LING system

Job description

Antelope Valley Medical Center in Lancaster, CA seeks an experienced RN Case Manager to prioritize, plan, and monitor patient progress within the hospital system. You will assess care utilization, promote continuity of care, and guide discharge planning while coordinating with medical staff and payers.

The role requires an RN license, a 2-year degree or higher, and 3+ years of acute care experience. This full-time position offers on-site work with a focus on efficient resource use and patient