RN - Case Manager

RN - Case Manager

Shift Details: Shift 08:00 AM - 04:00 PM, Shifts Per Week 5, Scheduled Hours 40

Job Order Details: Start Date 08/10/2026, End Date 11/09/2026, Duration 13 Week(s)

Job Description: CASE MANAGER RN NEEDED - 5/8s Every Other Weekend

Certification Requirements: CA RN LICENSE, BLS

Experience: 5+ Years of RN Case Management experience

Job Duties: Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self determination while coordinating in a timely and integrated fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. If assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions.

Job Accountabilities: Patient Initial and Continued Assessment. Reviews initial physician admission care plan. Gathers additional medical, psychosocial, and financial information from the patient/family interview, medical record assessment, physicians, and other health care providers. Determines moderate or high risk level for readmission. Conducts a screening for ancillary supportive services, including but not limited to Palliative Care Services needs. Functionally supervises and actively leads the health care team in developing comprehensive cost-effective care coordination plans that meet the clinical needs of our patients. Identifies and refers quality and risk management concerns to appropriate level for patient safety reporting and trending. Directs and oversees the Case Management Assistants to determine preferences for post-acute care services. Utilization Management. Reviews medical record to ensure patient continues to meet level of care (LOC) requirements and that chart documentation supports LOC determination and assignment. Works with Attending Physicians to confirm necessary documentation to support level of care (LOC). Expedites transition planning for patients who no longer require acute level of care. Monitors length of stay (LOS) and outliers requiring additional resources and/or focus. Collaborates with financial counselor for delivery of inpatient stay denials. Assures delivery of Medicare Important Message within 48 hours of discharge/transition and no less than 4 hours of actual discharge/transition. Actively participates in patient rounds following the standard work as developed and collaborates with interdisciplinary team to assure timely transition. Follows policies and procedures for Physician Advisor referrals. Utilizes appropriate escalation process when discussing level of care (LOC) requirements with providers. Consistently documents in the EHR and other electronic software. Maintains current knowledge of CMS and Joint Commission Transitions of Care requirements, Conditions of Participation (COPs), and other regulatory requirements. Effectively follows Observation patients, re-evaluates and collaborates with attending physician for admission or transition to appropriate level of care for the patient. Care Coordination/ Care Transitions. Formulates a transition plan after reviewing available/appropriate care options and obtaining input, and collaborating with the patient/family and physician, health care team, payers, and community based support services. Performs, documents, and communicates assessment findings to health care team. Screens 30-day readmissions; reviews previous hospital record confers patient/family and with interdisciplinary team to create an effective and realistic transition plan. Proactively identifies barriers to care progression and transition, and works with multi-disciplinary team to resolve timely. Addresses complex clinical and social situations efficiently in order to avoid unnecessary admissions, improper level of care utilization, and delays in transition. Reviews and modifys plan of care. Assures timely transition to lower level of care. Assesses the need for follow up appointments and when applicable communicates to patient/family prior to transition. Assures necessary paperwork for post-acute transfers to comply with state and federal regulatory requirements. Identifies patients appropriate for case management intervention by reviewing the electronic health record (EHR) and meeting with patients and collaborating with staff and physicians Follows locally determined resources and workflows for patient transfers. Actively participates in ongoing department operations. Identifies new system, processes, protocols and/or methods to improve practices. Actively contributes to the creation of cost effective practices that ensure the best patient/provider experience, effective resource utilization, and safe outcomes. Effectively communicates with Care Management colleagues for safe transitions. Actively aware and manages all communications (email, KDS, Policies & Procedures, Handoffs, and other) and participates in all department meetings. Uses effective interpersonal and communication skills to promote customer service with internal and external customers. Develops and maintains positive, productive, and professional relationships with the healthcare team and representatives of community agencies. Relates with tact and respect to all customers with diverse cultural and socioeconomic backgrounds without personal judgment. Be a positive participant, actively engaged in all department operations. Willingly provides and accepts direct, constructive feedback to and from colleagues and the leadership team. Actively uses effective communication skills with colleagues to resolve issues in a timely manner.

Submittals: Med Job Requirements & Qualifications Previous Charge Experience : Preferred Years of Experience : 2 Patient Ratio Experience : 10 Charting System Experience : - Charting System Name : Epic Community Hospital Experience : - LTAC Experience : - Trauma Level I Experience : - Trauma Level II Experience : - Travel Experience Required : - Certifications : BLS, CA RN License Skills : Acute Hospital, Care coordination, Discharge Planning

Unit Details Staffing & Scheduling Scheduling Type : - Patient Ratios Days : 15 Patient Ratios Nights : - Patient Ratios Weekends : 25 Float Required : - Call Required : - Weekend Coverage : True Number of Weekend Shifts Per Contract : - Pre-Approved Time Off : - Orientation Hours : - Facility & Patient Care Details Patient Age Groups : Adults, Geriatrics Daily Census : - Number of Visits Per Day : - Number of Rooms : - Number of Beds : - Additional Unit Information Interdisciplinary Support : - Patient Diagnoses : - Special Procedures/Unit Details : - Special Equipment : - #Tier3 Travel Compliance Sutter Submission Rules: Local candidates: Locals accepted at local rate; 50-mile radius rule RN Licensure: Uploaded Nursys within the last 2 weeks with Valid CA State License Certifications: Uploaded any applicable certifications with valid expiration dates Certifications must be AHA or ARC References: 2 references obtained within the last year Return Staff/Travelers: No separation time required. Former manager(s) name needed on application Experience: Unless otherwise stated, at least 2 years of experience required BG/Licensure Hits: Any hits with supporting documentation will need to be disclosed to seek approval from facility HR to proceed with application RTO Policy: Max RTO: 7 days per contract Holiday RTO: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day. Holidays begin at 7:00 PM the night before the holiday, and end at 7:00 AM the day after the holiday Only 1 holiday per contract can be requested Compliance: Onboarding: Must complete labs within 3-5 days of contract signing Work History Verification: 7-Year Work History Verification Required for all candidates. Candidates must provide accurate work history information going back 7 years from their start date and may also be required to provide documentation or contacts for the verifications if we are unable to verify any positions Deadline: All compliance documents due 10 days prior to start Re-Orientation : re-orientation only required if travelers have been separated for 6+ months since last shift and IF orientation was completed at Alta Bates Summit Medical Center Modules: Modules are non-billable. An average of 1-5 hours spent on modules and are factored into NBO. Any time spent on modules exceeding the 16 NBO hours are billable Modules are completed during orientation, and module hours vary by specialty Modules are recorded through e-learning

Guaranteed Hours: Contract Weeks:91 Client Details Address 350 Hawthorne Ave City Oakland State CA Zip Code 94601