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RN - Case Manager

Adventist Health System West - AS

Health Plan Care Manager

Manages the development, implementation, and evaluation of care management service lines. Enhances the quality of member management by promoting continuity of care and cost-effectiveness. Integrates whole person in-patient and out-patient management, care integration, case management, utilization review, and care planning. Partners with internal and external physician advisors, as well as claims and data management departments. Provides safeguards, processes, and expected outcomes for the member population. Performs and/or coordinates preventative care, wellness, and nutritional counseling. Develops and maintains positive relationships with internal and external customers. Collaborates with physicians, staff, and leadership on quality and performance improvement activities. Focuses on optimal utilization of resources and efficient delivery of high-quality care. Ensures patient flow, capacity management, and other clinical cost reduction initiatives. Performs ongoing collaboration with staff to ensure that a member's medical condition meets medical necessity criteria. Communicates changes that could affect the discharge plan of care. Manages communication related to discharge planning and utilization management. Performs other job-related duties as assigned. Commits to the safety and well-being of associates and members. Requires that all associates receive all required vaccinations as a condition of employment, where applicable.

We offer competitive benefits, including:

  • Medical, dental & vision insurance
  • Free and unlimited continuing education units (CEUs)
  • 24/7 dedicated Care Line and clinical liaison support
  • Personalized career consultant and "single point of contact" service
  • Industry‑leading pay rates, loyalty rewards & referral bonuses
  • Free tax return assistance for travelers
  • 401(k) Retirement Plan
  • Health Savings Account (HSA)
  • Disability Insurance (Short-Term and Long-Term)
  • Life and AD&D Insurance
  • Paid Sick Leave (where required by applicable state or local law)
  • Supplemental Insurance Plans
  • Identity Theft Protection
  • Pet Insurance
  • Employee Wellness Programs
  • Employee Assistance Program (EAP)
  • Career Growth and Professional Development Opportunities

Benefits eligibility, accrual rates, and usage limits may vary based on employment status, length of service, and work location. Paid Sick Leave is provided in strict accordance with applicable state and municipal mandates. Cynet Health reserves the right to modify, amend, or terminate any benefit plans at any time in accordance with applicable laws.

Cynet Health is a Joint Commission-accredited, Minority-Owned healthcare staffing agency headquartered in Sterling, Virginia, proudly serving healthcare facilities across the United States since its founding in 2010. As one of the nation's largest and fastest‑growing healthcare staffing firms in the nation, we staff thousands of nursing, allied health, locum tenens, pharmacy, therapy, direct‑hire, and non‑clinical professionals across hospitals, clinics, long‑term care facilities, labs and more. We're one of the most decorated staffing agencies in America-ranked a Top Travel Nursing Company by BluePipes, recognized among the fastest‑growing and most diverse staffing firms by Inc. 5000, Staffing Industry, WBJ and USPAACC-and remain deeply committed to excellence, inclusion, and community impact.

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Vacancy posted 23 hours ago
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