Registered Nurse Case Manager Capital Staffing Solutions Placentia, CA Job Details Temporary | Full-time | Contract $50

• $58 an hour 22 hours ago Benefits Health insurance Dental insurance Vision insurance 401(k) matching Qualifications Collaborate with healthcare professionals Computer operation Utilization review RN License Customer service Bachelor of Science Employee relationship building English Managing patients as a nurse case manager Transitional care planning in clinical case management Utilization management Care coordination meetings experience Bachelor of Science in Nursing Concurrent review in utilization management Bachelor's degree in nursing Computer skills Full Job Description Job Title 37728386•Case Manager•Placentia, CA Duration 10/26/2026 to 01/23/2027, Likely to extend Location 1301 North Rose Drive, Placentia, CA 92870 Pay Rate 50-58 H DOE Hours/Shifts Full-Time Monday•Friday 8:00am•5:00pm

MUST HAVE REQUIREMENTS

Covid vax or exemption Bachelor of Science in Nursing (BSN) Current RN license 5+ years clinical experience 1+ year Case Management experience Utilization review / medical necessity experience InterQual or similar utilization review criteria experience Discharge planning / transitions of care experience Understanding of patient acuity and appropriate levels of care

PREFERRED REQUIREMENTS

CCM, ACM, or other Case Management credential California Children's Services (CCS) experience Joint Commission, CMS, or CDPH knowledge

Bilingual Job Title:

Case Manager Keywords:

Number of Positions:

1

Remaining Positions:

1 Here is the complete, full job description formatted with clear sections, bullet points, and bold text for easy reading without leaving out any of the original details: Job Summary Incumbent is responsible for a high level assessment and reassessment process for the patient/family to set priorities, plan, organize, and implement care that is goal-directed toward self-care outcomes. Collaborates with an interdisciplinary approach to care facilitation to promote and coordinate the delivery of high quality, individualized, safe and cost-effective patient care and transitions of care. Advocates for patient self-determination and choice. Practices cultural competence in evaluations and planning with awareness and respect for patient and family diversity. Monitors and coordinates resource utilization throughout the health system and evaluates services provided. Performs utilization review functions utilizing medical staff-approved decision support criteria (InterQual Intensity of Service, Severity of Illness criteria). Concurrently intervenes to enhance patient quality outcomes where appropriate. Ensures clinical information in the medical record is clear and complete reflecting the patient's true severity of illness through interfacing with physicians to improve the overall quality of the clinical documentation.

Job Responsibilities Patient & Caregiver Participation:

Participates in the care of the patient and in caregiver meetings; respecting and promoting the patient's self-determination, informed and shared decision making, autonomy, growth and self-advocacy.

Goal Setting:

Develops long and short term goals consistent with treatment plans, standards of practice, and the patient's plan of care.

Discharge Planning & Compliance:

Completes appropriate and timely discharge planning assessments and reassessments and documents concurrently in the patient's medical record in compliance with hospital policy and State and Federal regulatory requirements (i.e. as

CDPH, TJC, CMS

).

Interdisciplinary Collaboration:

Collaborates as needed with the patient and family to optimize client outcomes.

Care Coordination & Transitions:

May include work with community, local and state resources, primary care provider, members of the health care team, payer, and other relevant health care stakeholders to facilitate appropriate patent transfers, discharges and transitions of care.

Alternative Levels of Care:

Identifies timely and effective alternative lower level of care settings for patient care in accordance with the patient's medical necessity, stability, the patients' preferences and health plan benefits.

Post-Hospital Care:

Identifies timely post-hospital nursing care needs and arranges for services as appropriate.

Resources & Referrals:

Provides patient and family appropriate resources and/or referrals. Makes timely and appropriate referrals to, and seeks consultation with others when needed, the patient-centered provision of services; such as Social Services (i.e., Durable Power of Attorney).

Utilization Review:

Applies Decision Support criteria (InterQual guidelines and/or other hospital approved utilization review criteria) to determine appropriate level of care and length of stay. Ensures utilization review is completed and documented concurrently and provided to the patient's payer as required.

Medical Staff Liaison:

Acts as an effective liaison to medical staff to ensure continuity and congruity of hospital services in accordance with the patient's plan of care.

Organizational Success:

Responsible for the achievements and success of UC Irvine Health.

Professional Conduct:

Follows through and meets commitments; accountable for own actions and supportive of colleagues; presents self in appearance and actions in a manner that conveys professionalism and pride in area of responsibility; projects a positive presence and ensures that work related or personal frustrations are kept separate from patient care and professional activities; takes responsibility for problems and solutions; follows existing policies and procedures. Skills & RequirementsRequired Skills & Experience Minimum five (5) years of clinical experience. Minimum one (1) year of previous Case Management experience. Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties. Must possess complete understanding of acuity levels for specific patient population. Must demonstrate customer service skills appropriate to the job. Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. Ability to facilitate and lead interdisciplinary rounds. Ability to establish and maintain effective working relationships across the Health System. Excellent written and verbal communication skills in English. Computer literacy and proficiency. Preferred Skills & Experience Knowledge of University policies and procedures. Knowledge of California Children's Services benefits authorization process (CCS). Familiarity of Joint Commission, CMS, CDPH. Bilingual skills. EducationRequired Education A Bachelor of Science in Nursing . Preferred Education N/A Certifications & LicensureRequired Certifications & Licensure Current RN License Preferred Certifications & Licensure CCM (Certified Case Manager) ACM (Accredited Case Manager) Case Management credentialing #aj1

Pay:

$50.00

• $58.

00 per hour Expected hours: 40.0 per week

Benefits:

401(k) matching Dental insurance Health insurance Vision insurance

Work Location:

In person