RN Case Manager, CCH

Job Description

Job Description

Overview

Opportunities for you!

• Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek

• Free Continuing Education and certification

• Tuition reimbursement, education programs and scholarships

• Vacation time starts building on Day 1, and builds with your seniority

• Free money toward retirement with a 403(b) and matching contributions

• Great food options with on-demand ordering

• Free parking and electric charging

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.

Responsibilities

The RN Case Manager is responsible for actively managing and advocating for patients. The Case Manager will be responsible for having comprehensive knowledge of the patient's medical status and performing utilization reviews to ensure care is rendered in accordance with intensity of service and severity of illness standards at all times. The Case Manager will consider physical, psychosocial, and financial assessment information in planning for, coordinating, and implementing a patient specific plan of care. Case management will include: educating patients about medication; encouraging adherence; promoting risk reduction and healthy lifestyle choices; and following up with patients to ensure medication is taken, appointments are made, and labs are completed. The Case Manager will work with providers and other multidisciplinary team members, utilizing a proactive approach, to ensure that medical care is provided based on current standards of care.

• Role Type: Hybrid remote . Nurses are required to be on-site at our Fresno location for a minimum of 2-3 days per week. Based on Operational and business needs, employee may be required to work on-site full time.

• Schedule: Standard operating hours are 8:00 AM to 5:00 PM, Monday through Friday, with a one-hour rotating lunch break. Overtime (OT) is possible but must be pre-approved.
• Focus : The role is general but with a strong focus on Utilization Management and Case Management across the board.
• Key Soft Skills : The ideal candidate must be a strong team player and capable of working independently. They must be able to triage and make decisions based on policy, with great communication skills for interacting with doctors

Qualifications

Education

• High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
• Bachelor's Degree in Nursing preferred

Experience

• 2 years of experience as a Registered Nurse with experience in discharge planning, case management, or utilization management required or 5 years of LVN experience in discharge planning, case management, or utilization management required
• Strong, specific experience in Case Management and Utilization Management/Review is highly preferred

Licenses and Certifications

• RN - Current and valid Registered Nurse license to work within the state of California required
• BLS - Current Basic Life Support (BLS) for Healthcare Providers by American Heart Association (AHA) required
• ACM - Accreditation in Case Management preferred
• CCM - Certified Case Management preferred