RN Case Manager

RN Case ManagerThe RN Case Manager coordinates patient care across the continuum in an acute, Level I trauma, tertiary academic medical center. This role conducts initial assessments for patients in observation or inpatient levels of care, develops safe and viable discharge plans with patients and their support systems, and collaborates closely with a multidisciplinary team to ensure appropriate utilization of resources. The RN Case Manager partners with utilization review nurses and case management assistants to support authorization of care and post-acute referrals while applying clinical expertise, independent judgment, and a patient-centered care model.Responsibilities:Perform comprehensive initial case management assessments for patients in observation and inpatient levels of care to identify discharge planning needs and care coordination requirements.Develop individualized, safe, and viable discharge plans in collaboration with patients, family members, and caregivers to ensure appropriate post-acute care and support.Coordinate care across the continuum by working closely with physicians, nurses, therapists, social workers, and other members of the multidisciplinary team.Participate actively in multidisciplinary rounds to communicate patient needs, discharge plans, and barriers to transition of care.Collaborate with utilization review nurses to monitor and support authorization of care from admission through discharge.Work with case management assistants to manage and facilitate post-acute referral processes, including placement in appropriate facilities and services.Apply the nursing processassessment, care planning, intervention, and evaluationwithin a patient-centered professional practice model, integrating case management functions.Maintain a solid working knowledge of specialized case management and utilization management methodologies and practices and apply them consistently in daily work.Ensure that medical necessity and medical appropriateness criteria are met and documented for the level of care provided from admission through discharge.Oversee implementation of an interdisciplinary plan of care that is well thought out, comprehensive, and aligned with the patients ongoing healthcare needs.Reevaluate the plan of care regularly and adjust discharge and care coordination plans based on changes in the patients condition and needs.Assist with authorization of post-acute care services, including skilled nursing, rehabilitation, home health, and other community-based resources.Complete utilization reviews when needed or assigned, ensuring compliance with organizational policies and regulatory requirements.Engage in opportunities to directly or indirectly influence decision-making related to bedside clinical practice and care coordination.Exhibit a positive, adaptable mindset in response to changes in workforce dynamics, clinical practice, and operational settings.Work efficiently in a fast-paced environment while exercising discretion and independent judgment in all aspects of case management.Communicate clearly and professionally with patients, families, caregivers, and the healthcare team to support understanding of care plans and transitions.Work calmly and respond courteously under pressure, maintaining professionalism in challenging situations.Support the organizations mission of providing comprehensive, competent, and compassionate healthcare within an academic, learning-focused environment.Essential Skills:Active and unencumbered California RN license.Current Basic Life Support (BLS) certification provided by the American Heart Association.Bachelors degree in Nursing (BSN) required.Minimum of 2 years case management experience, preferably in a Level I trauma facility.Minimum of 2 years inpatient acute care experience in a non-emergency department, non-clinic setting.Minimum of 1 year hospital case management or hospital utilization management experience.Demonstrated experience in discharge planning in an inpatient acute care environment.Strong knowledge of case management and utilization management practices and methodologies.Working knowledge of state and federal healthcare regulations and accreditation requirements related to case and utilization management.Proven ability to perform comprehensive initial assessments, care coordination, and develop safe, viable discharge plans.Ability to work efficiently in a fast-paced acute care setting while exercising independent clinical judgment.Strong interpersonal and communication skills to collaborate effectively with multidisciplinary teams and engage patients and families.Ability to remain calm, courteous, and professional under pressure and during complex or challenging situations.Availability and willingness to work every other weekend.Additional Skills & Qualifications:Nationally recognized certification in Utilization Management or Case Management preferred.Experience in a large academic medical center or tertiary care environment is highly desirable.Experience in care coordination within a Level I trauma hospital setting.Familiarity with Duffys Quality-Caring Model or similar patient-centered care frameworks.Demonstrated commitment to continual learning and professional development.Ability to positively adapt to changes in clinical practice, workflow, and operational processes.Strong organizational and time-management skills to balance multiple cases and priorities.Comfort working within a large case management team and contributing to shared goals and best practices.Work Environment:This role is based in a large, 400-bed, Level I trauma, tertiary academic medical center that emphasizes continual learning, research, and professional development. The RN Case Manager works primarily in an inpatient acute care setting, collaborating with a broad multidisciplinary team in a fast-paced, dynamic environment. The position follows a daytime AM shift schedule, typically from 8:30 a.m. to 5:00 p.m., with a requirement to work every other weekend. The organization maintains a comprehensive, compassionate, and mission-driven culture focused on high-quality, patient-centered care and offers a robust case management team that supports mentorship and career pathing. Clinical attire appropriate for an acute care hospital is expected, and staff use standard hospital technologies and electronic systems to document care, manage utilization reviews, and coordinate post-acute services.Job Type & Location:This is a Contract position based out of Loma Linda, CA.Pay and Benefits:The pay range for this position is $50.00 - $75.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)