Registered Nurse III-V - Public Health- CMS- Enhanced Care Management
County of Riverside
Overview For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. About The Position The County of Riverside- Riverside University Health System- Public Health is currently recruiting for a Registered Nurse III-V for the Children's Medical Services - Youth Enhanced Care Management department located in Moreno Valley. This program ensures that California Children Service's (CCS) eligible children receive medically necessary, timely and coordinated care. This program serves children and youth with special health care needs and their families across Riverside County. Bilingual in Spanish is required. Incumbents in this position provide comprehensive nurse case management services to Enhanced Care Management (ECM) California Children’s Services clients, including intake, assessment, care planning, service coordination, and transition support. The selected candidate will facilitate multidisciplinary case conferences with healthcare providers and manage care plans to effectively address and resolve barriers to care and authorization requirements. Responsibilities also include maintaining timely and accurate documentation in Epic, monitoring caseload performance metrics, and preparing materials for audits and compliance reviews. Additionally, incumbents educate families on care plans, medications, medical equipment, and navigation of complex healthcare systems. This position supports quality improvement initiatives and respond to escalated issues in a professional and timely manner. Countywide travel to partner sites and clinics is required, and a valid California driver’s license is mandatory. Highly competitive candidates will demonstrate experience in pediatric nursing and care coordination, as well as a strong working knowledge of California Children’s Services, Medi-Cal managed care, and CalAIM Enhanced Care Management programs. Required Licenses And Certifications A Current CA Registered Nurse License. Basic Life Support (BLS) certification issued by the American Heart Association. Public Health Nursing Certificate. (Can obtain within 6 months of hire) Certified Case Manager (Preferred not required) A valid CA Driver's License. Salary Range Registered Nurse III: ($47.8934 - $71.2295) Registered Nurse IV: ($51.2460 - $75.1470) Registered Nurse V: ($56.4843 - $79.2800) Schedule 9/80, With every other Friday off. Meet the Team! Riverside University Health System – Public Health is one of California’s largest and most dynamic public health departments, with dedicated professionals working to keep our communities safe and healthy. From disease prevention and health education to nutrition, emergency response, and community outreach, our team’s impact reaches every corner of Riverside County. If you're passionate about making a meaningful impact on community health and well-being, consider joining our team at RUHS-Public Health. Together, we can work towards a healthier future for Riverside County. For more information on RUHS–Public Health, please visit Examples Of Essential Duties Within the full scope of the Nurse Practice Act, may assess, plan, organize, provide and/or oversee nursing care to patients in accordance with physician instructions; may make preliminary observations of, and prepare patients for, medical treatment. Participate in or provide leadership to/chairs, various committee meetings and present and/or gather data and information to assist management in making administrative and operational decisions. Participate or provide leadership in committee activities related to performance improvement issues by auditing patient records and presenting performance improvement plans to the department staff at least two times annually; review and/or revise policy and procedures to maintain up to date policies at all times; participate in in-service education and staff development activities by teaching classes at least two times a year. Participate or provide leadership in the development of standards of care activities; serve as a preceptor and ongoing mentor to nursing staff; assign and monitor work of a patient care unit, to ensure quality and productivity standards are met; act as a resource to other units as assigned and actively support the nurse manager and supervisory staff. Conduct research and special unit studies to enhance the professionalism, quality standards, and customer satisfaction of the unit or department. Identify need for new nursing or mental health procedures and protocols; initiate draft of these procedures and protocols; facilitate throughout the administrative process and initiation into practice at the department level. Assess training needs of the assigned unit, and recommend and develop programs to meet these needs; teach classes to meet the training needs of the unit or multiple departments as assigned, at least twice a year. Draft recommendation standards of care, policies, procedures, and quality indicators as identified or assigned; provide education for the staff and monitor compliance to reach established goals. May be responsible for oversight, development, implementation, and coordination of special programs, services, and education in the healthcare setting. Minimum Qualifications Registered Nurse III: Education: Successful completion of the education required to obtain a valid license to practice as a Registered Nurse in the State of California. Experience: Three years of full time experience as a Registered Nurse in an acute care facility, mental health facility, or community health agency with references and evaluations to show appropriate skill level. (A bachelor's degree from an accredited college or university in nursing or national certification in a nursing specialty may be considered as a substitution for one year of the required experience. A master's degree from an accredited college or university in nursing may be considered as a substitution for two years of the required experience.) Registered Nurse IV Education: Graduation from an accredited college or university with a bachelor's degree in nursing or health-related field or current and valid national certification in nursing or health-related field. Experience: Six years as a full-time Registered Nurse. Some positions may require two years in a specialty area. A master's degree from an accredited college or university in nursing or a health-related field may be substituted for two years of the required experience. Registered Nurse V Education: Graduation from an accredited college or university with a bachelor's degree in nursing or a health-related field, and a current and valid national certification in nursing or health related field. Experience: Nine years as a full time Registered Nurse with at least two years in a specialty area. OPTION I Education: Graduation from an accredited college or university with a bachelor\'s degree in nursing or a health-related field, and a current and valid national certification in nursing or health related field. Experience: Nine years as a full time Registered Nurse with at least two years in a specialty area. OPTION II Education: Graduation from an accredited college or university with a master\'s degree from an accredited college or university in nursing or health-related field. Experience: Seven years as a full-time Registered Nurse with at least two years in a specialty area. ALL OPTIONS Knowledge of: Teaching and/or supervising the current principles, techniques and procedures used in professional nursing; medical terminology and patient care routine appropriate to clinical setting; medical instruments and equipment; the uses and effects of medicines and narcotics; community resources available to provide patient care and follow-up; federal, state and local laws and regulations governing professional aspects of nursing. Ability to: Perform, supervise and instruct in the full range of nursing duties and responsibilities in a patient care setting; plan and organize nursing plans for patients; prepare and maintain concise and complete records and reports; establish and maintain effective working relationships with physicians, patients, co-workers, and other outside healthcare providers; secure the cooperation of employees to work effectively together; keep abreast of developments in areas of nursing specialization; teach, mentor and supervise others routinely; may be assigned to any unit to fill in temporarily to assist staff or a supervisor; effectively prepare and present reports and recommendations both orally and in written form; collect and evaluate data, draw conclusions and formulate recommendations. Supplemental Information Application Status How to confirm your application was received or check on the status of your application, log-in to , click on your name in the upper right corner, and click on “Applications & Status.” Sign Up for Job Alerts Go to , click on “Careers,” click on “County Job Openings,” and click on “Subscribe to Job Alerts” icon. For questions regarding this recruitmen t please contact Denise DeCamp at View phone number on click.appcast.io, or View email address on click.appcast.io . Please allow 1-2 business days for a response to general inquiries. ________________________________________________________________________________________ APPLICATION INFORMATION Veteran's Preference The County has a Veterans Preference Policy applicable to new hires. To qualify, attach the required documents to your job application. Documents include a copy of your (or your spouse's) Member-4 Form DD-214 indicating dates of service. For spousal preference, and as applicable, the following documents: a copy of your marriage certificate, spouse's death certificate, a letter of spouse's disability and/or letter of service-related death (if available) from the U.S. Veteran's Administration. For privacy reasons, it is recommended that you remove your social security information from the document(s). A Human Resources Representative will review the materials and determine if you qualify for veterans' preference. For complete details and documentation requirements, please review the Veterans Preference Policy, C-3 here: Reasonable Accommodations The County of Riverside is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter for the position noted above. For additional information and/or to obtain the appropriate form for requesting a reasonable accommodation, please visit the Disability Access Office web page located at: Proof of Education If using education to qualify or when requested by the recruiter, upload a copy of any license(s), official/unofficial transcript(s), degrees, and/or related employment documents to your NeoGov account at the time of application and before the closing date. Official or unofficial transcripts will be accepted. If your education was completed outside of the United States, you will need to provide a copy of your Foreign Education Equivalency evaluation from a member of the National Association of Credential Evaluation Services ( NACES ) or Association of International Credential Evaluators, Inc. ( AICE ). Work Authorization Requirement Applicants must be legally authorized to work in the United States at the time of application. The County of Riverside does not participate in visa sponsorship programs, including H1-B visas, and will not provide sponsorship for any employment-based visas. Equal Opportunity Employer The County of Riverside is an Equal Opportunity Employer. It is the policy of the County of Riverside to provide equal employment opportunities for all qualified persons. All applicants will be considered without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition (cancer and genetic characteristics), genetic information, or denial of medical and family care leave, or any other non-job-related factors. Pre-Employment All employment offers are contingent upon successful completion of pre-employment requirements including a criminal background investigation, which involves fingerprinting. (A felony or misdemeanor conviction may disqualify the applicant from County employment). A pre-employment physical examination and background check may be required. Probationary Period As an Approved Local Merit System, all County of Riverside employees, except those serving "At Will," are subject to the probationary period provisions as specified in the applicable Memorandum of Understanding, County Resolution, or Salary Ordinance. Temporary and Per Diem employees serve at the pleasure of the agency/department head. General Information Current County of Riverside and/or current employees of the hiring department may receive priority consideration. Qualified candidates may be considered for future County vacancies. Job postings may close without notice based on application volume. Submit your complete application by the recruitment close date; no late applications are accepted. Ensure all relevant experience/education is reflected on your application/resume, as a failure to demonstrate position requirements may disqualify applicants. A description of job duties directly copied from the job classification or job posting will not be considered. Please read and follow any special application instructions on this posting. Click the ' Apply ' link located on this page to submit your application. For additional instructions on the application process, examinations, Veteran's preference, pre-employment accommodation or other employment questions, please refer to our web site, . If you are experiencing technical problems, you may contact the governmentjobs.com applicant support desk Monday through Friday, 6 am to 5 pm Pacific Time at View email address on click.appcast.io or toll-free View phone number on click.appcast.io. #J-18808-Ljbffr
$104.83k - $162.48k
...compassionate and comprehensive care to underserved communities... ...aims to improve the health of diverse communities. Our... ..., integrated care. The Registered Nurse (RN Case Management (CM) Manager) is responsible... ...family and caregivers to enhance the continuity of care for...CmsWork at officeLocal area$85.7k - $128.54k
...a Supervisor for Utilization Management in California. The role includes... ...and ensuring compliance with CMS regulations. The ideal candidate... ...experience, an accredited nursing background, and must hold an active... ...Knowledge of Medicare Managed Care and strong analytical skills...Cms$44.58k - $62.31k
...Riverside - Riverside University Health System (RUHS) Behavioral Health is seeking a dedicated Registered Nurse II/III to join their Quality... ...organize, and provide nursing care to assigned patients in accordance... ...in the State of California. Public Health Nurses must possess...SuggestedFull timeInterim roleLocal area- ...The County of Riverside is seeking a Registered Nurse III-V for the Children's Medical Services in... ...position involves providing nurse case management for children eligible under California... ...have experience in pediatric nursing, care coordination, and must be bilingual in...Suggested
$60.6k - $91k
Clinical Specialist, Quality Management & Training Care Management California, United States Because health is personal. That's why... ...regulations, including HIPAA, CMS, NCQA, and URAC. Ability... ...Holds an active unrestricted Registered Nursing License Required May...CmsWork at office$85.7k - $128.54k
...Supervisor, Utilization Management (UM), reports to the... ...ensuring compliance with CMS regulations.... ...to CMS and Alignment Health turnaround times. Promote quality patient care outcomes while supporting... ...completion of an accredited Registered Nursing Program or Vocational...CmsRemote jobLocal area$85.7k - $128.54k
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and... ...innovation. Utilization Management Nurse Lead Responsibilities... ...Vocational Nursing or Registered Nursing Program. Specialized... ...Care Manuals and CMS regulatory...CmsRemote jobImmediate start- ...977 as the Senior Care Action Network, SCAN... ...is a nonprofit health organization serving... ...or skilled nursing facilities. This includes... ...chronic disease management. Identify patient... ...reviewing professional publications. Contribute to... ...management. Knowledge of CMS guidelines and...CmsWeekend work
- ...supervision, the Clinical Nurse III applies nursing... ...provide direct patient care, initiating and... ...Coordinator, Assistant Nurse Manager, Public Health Nurse, and... ...Qualifications Active California Registered Nurse License without... ...strategies to enhance patient care. Model high...Full timeWeekend work
$73.1k - $142.55k
...and cost‑effective member care. The Program Manager plans and executes internal... ...Qualifications At least 5 years of health care experience, including... ...education and experience. Registered Nurse (RN), Licensed Vocational... ...Employer (EOE) M/F/D/V. #J-18808-Ljbffr Molina HealthcareCmsContract workWork experience placementWork at office$95k - $140k
...Position: Job Lead, Sales Manager (manage and support... ...retention, and model of care goals. Responsibilities... ...programs implemented by CMS and approved scripts... ...and group meetings that enhance enrollment within the assigned... .... Must hold a CA Health Insurance License. Proficiency...CmsImmediate start- Bargaining Unit: CNA - Registered Nurses Unit Contra Costa County Health Services Department offers... ...following assignments: Public Health, Behavioral Health... ..., evaluates patient care outcomes and documents all... ...evaluates care Performs case management Monitors laboratory...Full timeWork at officeLocal areaShift work
$125.4k - $181.42k
...Sr. Manager, Quality Assurance and Compliance page is... ...in 1977 as the Senior Care Action Network, SCAN began... ..., SCAN is a nonprofit health organization serving more... ...obligations, and enhancing operational processes.... ...environmentStrong working knowledge of CMS and state regulations...CmsFor contractorsRemote work$30 - $35 per hour
...Department: Enhanced Care Management (ECM) Reports To: Registered Nurse Clinical Case Consultant Classification: Non-Exempt... ...Open Positions: 2 About Pacific Health Group At Pacific Health Group, we... ...healthcare, managed care, home health, public health, behavioral health, post‑...Hourly payTemporary workWork at officeLocal areaRemote workMonday to FridayFlexible hoursAfternoon shift$45.75 - $80.24 per hour
...The County of Riverside is hiring a Registered Nurse II/III for the Express Care clinic in Corona. The role involves managing a team and providing nursing care for patients. Candidates should have a valid RN license in California and experience in urgent care is preferred...Hourly payFull timeShift work- ...To provide support and facilitate care for members who require case management. To work collaboratively with the Health Plan and Hospital Case Management Departments to facilitate... ..., and BH. The case manager is a licensed nurse (RN or LVN). A care manager can be a...Cms
$45 - $55 per hour
...Quality Assurance Registered Nurse (RN) - Home Health page is loaded## Quality Assurance... ...align with patient condition, care guidelines, and... ...In‐depth understanding of CMS regulations, Medicare Conditions... ...subsidiary that has its own management, employees and assets....CmsHourly payFull timePart timeSecond jobRemote work- ...Description The On-Call Registered Nurse (RN) is a California-... ...after-hours medical management coverage when the Medical... ...management (UM), care coordination, discharge... ...state, accreditation, and health plan requirements... ...Milliman Care Guidelines, CMS requirements, NCQA...CmsWork experience placementWork at officeNight shiftWeekend workAfternoon shift
- ...Bargaining Unit: CNA - Registered Nurses Unit The Contra Costa County Health Services... ...Incumbents provide medical care to individuals and... ...Services, Public Health Clinic Services... ...primary care and case management to individuals and... ...Services (CMS). A background investigation...CmsFull timeWork at officeLocal area
$51.88 - $76.28 per hour
...general supervision of the CM Director the nurse case manager manages clinical resource utilization... ..., vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge... ...collaborate with members of the health care team in removing barriers to discharge...CmsShift work$20 - $30 per hour
...Member Appeals & Grievance Case Manager for a 6+ month contract with long... ...and grievances in compliance with health plan standards. Ideal candidates... ...years of experience in Appeals or Care Coordination, with a strong understanding of CMS regulations. The position offers...CmsRemote jobHourly payContract work$100 per hour
...Becoming a Doctor of Nursing Practice (DNP) in... ...practice registered nurses ( APRNs )... ...nurse leaders, and health care innovators in diverse... ...attend in-state/public programs. Online... ..., and medication management. Nurse Anesthetist... ...organizations can enhance a DNP’s career...Full timeWork at officeFlexible hours- ...supervision of the PACE Home Care Coordination RN Manager, this role provides... ...clinical, DHCS, and CMS regulations and... ...Provide support to PACE nurses in the coordination... ...as directed. Maintain health and safety standards... ...California Department of Public Health Home Health...CmsShift work
- ...Concordia Visiting Nurses is a Medicare-... ...approved home health agency... ...nursing, palliative care, and a variety... ...are committed to enhancing the well‑being... ...Pennsylvania license as a Registered Nurse (RN) A... ...Services (CMS) and any other... ...requests. Manage requests for Medicare...CmsWork at office
$172.36k - $258.55k
...Overview Alignment Health is a fast‑growing company... ...of the APC care delivery model across... ...Ensure compliance with CMS, Medicare Advantage... ...virtual care, case management, IPAs, and external... ...opportunities to enhance clinical workflows,... ...of experience as a Nurse Practitioner or...CmsRemote work- Job Summary The Manager reports to the Director of the... ...and outcomes of clinical care teams and programs... ...personnel, administration, health plans, and third-party... ...Bachelor’s degree in Nursing required Master’s degree... ...including but not limited to: CMS, Title 22, CHA Consent...Cms
$87.05k - $115.27k
...bed, not‑for‑profit, acute‑care community hospital located... ...Director of Quality and Risk Management is a Registered Nurse (RN) responsible for... ...The Joint Commission (TJC), CMS, and other accrediting bodies... ...management to mitigate risks, enhance patient outcomes, and maintain...CmsDaily paidFull timeTemporary workPart timeLocal areaShift work$43.04 - $77.47 per hour
...for Patient Centered Care (PC2) program implementation... ...of disease and case management. How you will make an... ...and program design enhancements. Serves as the subject... ...i.e., CM, DM, Senior, Nurse Line). Partners with case... ...with Electronic Health Records (EHR), and knowledgeable...CmsWork at officeLocal area1 day per week- ...Registered Nurse III - Bronchoscopy - 12 Hour DaysCedars SinaiCaliforniaNEW! NEW!Director, Ambulatory... ...NurseVeterans Affairs, Veterans Health AdministrationPortland, OregonNEW! NEW!... ...Duties:**Provides professional nursing care to patients undergoing diagnostic or therapeutic...Daily paidFull timeSeasonal workFlexible hoursNight shift
- Job Description The Managed Care Compliance Specialist is responsible for assisting with the implementation of the... ...departmental activities, to assure compliance with all health plan and regulatory agencies, including CMS, DMHC, and DHCS. Duties and Responsibilities...CmsContract work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Registered Nurse III-V - Public Health- CMS- Enhanced Care Management. Be the first to apply!
- prn registered nurse California, MO
- pediatric rn California, MO
- home health rn California, MO
- nurse rn California, MO
- med surg medical surgical rn registered nurse California, MO
- ob gyn rn California, MO
- cath-lab rn California, MO
- non clinical rn California, MO
- kaiser rn California, MO
- registered nurse pharmacy California, MO

