Interim Registered Nurse Case Manager

Overview

• Coordinate patient care across disciplines to ensure optimal clinical outcomes and efficient resource utilization.
• Collaborate with interdisciplinary teams to develop individualized care plans aligned with best practices and regulatory standards.
• Facilitate timely transitions of care, including admissions, transfers, and discharges.
• Perform utilization reviews to ensure compliance with CMS, payer, and regulatory guidelines.
• Educate patients and families about care plans, treatment options, and post-acute services.
• Maintain accurate documentation in electronic medical records to support care management activities.
• Advocate for patient needs while balancing clinical quality, safety, and cost-effectiveness.
• Participate in quality improvement initiatives and performance metrics related to care management.

Key Responsibilities & Duties

• Assess, plan, implement, and evaluate patient care plans to support safe and effective care delivery.
• Coordinate care across disciplines, including physicians, nursing, social work, therapy, and ancillary services.
• Facilitate timely transitions of care, ensuring appropriate level of care and length of stay management.
• Perform utilization review activities in compliance with CMS, payer, and regulatory guidelines.
• Identify opportunities to improve throughput, reduce delays, and optimize resource use.
• Educate patients and families regarding care plans, treatment options, and post-acute services.
• Maintain compliance with state, federal, and accreditation standards, including CMS and Joint Commission policies.
• Communicate effectively with physicians, nursing leadership, and external providers to support patient-centered care.

Job Requirements

• Active California Registered Nurse (RN) license in good standing.
• Minimum 2 years of acute care nursing experience, with knowledge of case management principles.
• Associate of Science in Nursing (ASN) or equivalent educational background.
• Preferred certifications include CCM, ACM, or CMAC, or willingness to obtain.
• Experience working with Medicare, Medi-Cal, and managed care populations is advantageous.
• Familiarity with InterQual or MCG guidelines for care management is preferred.
• Strong clinical judgment, critical thinking, and organizational skills are essential.
• Excellent communication and interpersonal skills to collaborate effectively with interdisciplinary teams.