RN Case Manager, CCH

Community Medical Centers

$75K — $95K *
Hospitals & Medical Centers
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • High School Diploma or equivalent required.
  • Bachelor's Degree in Nursing preferred.
  • 2 years of experience as a Registered Nurse in discharge planning, case management, or utilization management required.
  • 5 years of LVN experience in relevant fields required if not an RN.
  • Strong experience in Case Management and Utilization Management/Review preferred.
  • Current RN license in California required.
  • Current BLS certification required.

Responsibilities

  • Manage and advocate for patients throughout their care journey.
  • Conduct comprehensive assessments including physical, psychosocial, and financial aspects.
  • Perform utilization reviews to align with care intensity and severity standards.
  • Educate patients on medication and promote adherence.
  • Encourage healthy lifestyle choices and risk reduction strategies.
  • Coordinate care with providers and multidisciplinary teams proactively.
  • Follow up with patients to ensure medications are taken and follow-up appointments are met.

Benefits

  • Commitment to diversity and inclusion.
  • Supportive team culture focused on high-level care.
  • Opportunity to work in a hybrid remote role with flexible scheduling.
Full Job Description
Overview

Opportunities for you! 

 

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. 

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. 

ResponsibilitiesThe RN Case Manager is responsible for actively managing and advocating for patients. The Case Manager will be responsible for having comprehensive knowledge of the patient's medical status and performing utilization reviews to ensure care is rendered in accordance with intensity of service and severity of illness standards at all times. The Case Manager will consider physical, psychosocial, and financial assessment information in planning for, coordinating, and implementing a patient specific plan of care. Case management will include: educating patients about medication; encouraging adherence; promoting risk reduction and healthy lifestyle choices; and following up with patients to ensure medication is taken, appointments are made, and labs are completed. The Case Manager will work with providers and other multidisciplinary team members, utilizing a proactive approach, to ensure that medical care is provided based on current standards of care. 
  • Role Type: Hybrid remote. Nurses are required to be on-site at our Fresno location for a minimum of 2-3 days per week. Based on Operational and business needs, employee may be required to work on-site full time. 
  • Schedule: Standard operating hours are 8:00 AM to 5:00 PM, Monday through Friday, with a one-hour rotating lunch break. Overtime (OT) is possible but must be pre-approved.
  • Focus: The role is general but with a strong focus on Utilization Management and Case Management across the board.
  • Key Soft Skills: The ideal candidate must be a strong team player and capable of working independently. They must be able to triage and make decisions based on policy, with great communication skills for interacting with doctors
   Qualifications Education
  • High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
  • Bachelor's Degree in Nursing preferred
  Experience
  • 2 years of experience as a Registered Nurse with experience in discharge planning, case management, or utilization management required or
  • 5 years of LVN experience in discharge planning, case management, or utilization management required
  • Strong, specific experience in Case Management and Utilization Management/Review is highly preferred
Licenses and Certifications
  • RN - Current and valid Registered Nurse license to work within the state of California required
  • BLS - Current Basic Life Support (BLS) for Healthcare Providers by American Heart Association (AHA) required
  • ACM - Accreditation in Case Management preferred
  • CCM - Certified Case Management preferred
Disclaimers

• Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.

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