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California, United States
Onsite
Job Description Summary
Manages a caseload of patients with complex or chronic conditions, applying RN-level clinical judgment to assess needs, coordinate care plans, facilitate transitions, and advance value-based care and health equity goals.<br><br>Clinical Case Manager, RN performs a range of clinical assignments under general supervision, applying working knowledge and growing experience to recognize patterns and identify when senior consultation is needed. Decisions are made within established protocols and involve non-complex to moderately complex clinical situations. This job broadens clinical capabilities across routine case types and strengthens judgment through increasing experience in the discipline.
How will you make an impact & Requirements
Key Responsibilities • Conduct comprehensive clinical assessments for patients with complex medical, behavioral, and social needs, developing individualized care plans within RN scope of practice. • Lead care coordination across multidisciplinary teams — including physicians, specialists, social workers, and community resources — to implement care plans and resolve barriers to care. • Manage care transitions including hospital discharge planning, post-acute placement, and follow-up monitoring to reduce readmissions and ensure continuity. • Apply clinical judgment to adjust care plans in response to changing patient conditions, escalating to physicians or supervising clinicians when appropriate. • Collaborate with payers on utilization management activities, authorization requirements, and documentation to support value-based contract performance. • Maintain accurate, timely case documentation and contribute to quality monitoring and reporting activities.
Compensation Range:
$38.97to
$70.15
The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.
