CrawlJobs Logo

RN Care Manager

kaiserpermanente.org Logo

Kaiser Permanente

Location Icon

Location:
United States , Salem

Category Icon
Category:

Job Type Icon

Contract Type:
Employment contract

Salary Icon

Salary:

52.52 - 80.11 USD / Year

Job Description:

Inpatient Care Managers are Registered Nurses who independently assure patients are admitted to the correct level of care for accurate billing and reimbursement, provide quality, cost effective clinical coordination/care management in acute care and emergency care settings, manage patients with routine and complex transition planning needs by: independently assessing needs, developing and implementing plans of care for transitions across care settings. Inpatient Care Manager also serve as expert consultants and educators for physicians and other health care team members for discharge and transitional care, coordination of internal and community resources, and support the evaluation and improvement of systems of care to support the optimal utilization of health care resources, while maintaining quality of patient care. The Inpatient Care Manager assumes primary accountability for anticipating, assessing, developing, implementing, documenting, advising, and communicating a safe transition plan of care for patients with complex care needs.

Job Responsibility:

  • Independently assure patients are admitted to the correct level of care for accurate billing and reimbursement
  • Provide quality, cost effective clinical coordination/care management in acute care and emergency care settings
  • Manage patients with routine and complex transition planning needs by: independently assessing needs, developing and implementing plans of care for transitions across care settings
  • Serve as expert consultants and educators for physicians and other health care team members for discharge and transitional care, coordination of internal and community resources
  • Support the evaluation and improvement of systems of care to support the optimal utilization of health care resources, while maintaining quality of patient care
  • Assume primary accountability for anticipating, assessing, developing, implementing, documenting, advising, and communicating a safe transition plan of care for patients with complex care needs
  • Coordinates post-discharge patient care needs to assure the timely and effective discharge of routine and complex patients from the hospital setting
  • Independently and proactively completes and documents patient assessments which are thorough, timely, age appropriate, and reflect psychosocial support systems, care needs, health plan benefits, level of care determinations for hospitalized patients
  • Coordinates and communicates with patients, families, and the health care team to develop mutually agreeable plans of care that optimize the use of resources to support the particular needs of individual patients
  • Facilitates resolution of issues which present barriers to safe transfers through the use of patient/team care conferences to assure the efficient transition to a lower level of care and to assure the patient/family receives the right care at the right time so that quality and utilization of resources are simultaneously enhanced
  • Ensures systematic and ongoing contact with interdisciplinary staff and continuing care services to assure the safe transition of patients across care settings
  • In collaboration with the interdisciplinary health care team, ensures regulatory and compliance standards are met
  • Perform duties as requested

Requirements:

  • Minimum of two years combine RN experience in the following areas: Med/Surg (hospital acute care)
  • ICU (hospital acute care)
  • Emergency Department
  • Home Health
  • Skilled Nursing Facilities
  • Hospice
  • Long Term Acute Care
  • Inpatient Rehab
  • Utilization Management
  • Successful completion of an RN program by date of hire
  • High School Diploma or General Education Development (GED) required
  • Registered Nurse License (Oregon) required at hire
  • Basic Life Support within 3 months of hire
  • Demonstrated ability to interrelate with physicians, nurses, support staff, and patients in interdisciplinary approach
  • Demonstrated ability to work as part of a team and work as a constant patient advocate
  • Basic physical, psychosocial, functional assessment skills
  • Familiar with care processes related to discharge and transitional facilities and services
  • Thorough knowledge of principles of teaching and delegation, assessment skills and care planning and appropriate utilization of acute hospital, long-term care and home care resources
  • Able to develop concise and thorough documentation of patient clinical assessment and care needs
  • Highly effective problem solving, written and verbal communication, customer service, organizational and time management skills
  • Ability to provide culturally competent care
  • Ability to navigate conflict in high pressure situations

Nice to have:

  • Certified in Case Management
  • Knowledge of appropriate utilization of acute hospital and Kaiser Permanente internal resources
  • Knowledge of Medicare and Medicaid regulations related to eligibility requirements: hospital, nursing facilities, home health, hospice, and Durable Medical Equipment (DME)
  • Knowledge of utilization management principles and tools
  • Demonstrated clinical judgment and customer-focused service skills
  • Knowledge of principles of patient teaching, disease prevention measures, and physical assessment as it relates to the needs of patient and the next level of care
  • BSN or bachelors degree and MSN
What we offer:
  • Medical, Vision & Dental
  • Retirement Plans
  • Tuition Reimbursement
  • Supportive Teams & Resources
  • Career Growth & Development

Additional Information:

Job Posted:
January 18, 2026

Employment Type:
Parttime
Work Type:
On-site work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for RN Care Manager

Embedded Transitional Care Manager RN

Oak Street Health takes a team-based approach to providing outstanding patient c...
Location
Location
United States , Rockford
Salary
Salary:
66575.00 - 142576.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • An active RN license within the state of practice in good standing
  • Willingness to obtain cross-state licensure, as needed
  • Certified Case Manager (CCM) or equivalent case management certification required, or willingness to obtain within 12 months of hire
  • 2+ years’ experience in transitional nursing, discharge planning, nursing case management, or home health
  • Experience in utilization management preferred
  • Knowledge of Medicare/Medicaid and NCQA regulatory transitions of care criteria
  • Exceptional communication skills and customer service orientation
  • Innovative and independent problem solving skills
  • Ability to monitor and evaluate opportunities for cost-effective care options with high-quality outcomes
  • Spanish-speaking preferred but not required
Job Responsibility
Job Responsibility
  • Manage patients through transitions of care
  • Advocate for the patient throughout the care continuum
  • Identify opportunities for improved program workflows
  • Maintain real-time and accurate records of patient status
  • Adhere to CMS, state specific and NCQA compliance criteria
  • Evaluate patient status post-ED visit or observation stay
  • Triage to determine appropriate follow up care
  • Engage directly with inpatient physicians, case managers, medical directors, and hospitalists
  • Coordinate with the Utilization Management team
  • Conduct structured clinical assessment to identify post-discharge needs
What we offer
What we offer
  • Paid vacation, sick time, and investment/retirement 401K match options
  • Health insurance, vision, and dental benefits
  • Affordable medical plan options
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access
  • Fulltime
Read More
Arrow Right

RN - Patient Care Manager

Serenity Hospice is seeking an RN Patient Care Manager for our Eugene, Oregon te...
Location
Location
United States , Eugene
Salary
Salary:
Not provided
arcadiahomecare.com Logo
Arcadia Home Care and Staffing - an Addus family company
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Possession of a current license to practice as a registered professional nurse or the equivalent license and education to practice as a healthcare professional in the practicing state
  • Minimum five years’ experience as a healthcare professional
  • including two years of supervisory experience in healthcare, homecare or hospice
  • Demonstrated administrative ability including knowledge of health care policies and program responsibilities
  • Valid driver’s license and proof of insurance is required
  • Must possess current CPR Certification
Job Responsibility
Job Responsibility
  • Oversee delivery of patient services and compliance with agency policies
  • Develop policies, procedures and guidelines to fulfill program objectives
  • Oversee scheduling, supervision, and on-going educational programs for all professional and paraprofessional staff providing direct patient services
  • Implement and monitor a quality assurance program or supervise designated QA staff
  • Oversee the maintenance of medical records, assuring accuracy, completeness and compliance with licensing regulations, certification standards, legal and ethical standards
  • Plan and implement staff education program for all team members
What we offer
What we offer
  • Great culture and team atmosphere
  • Comprehensive benefits, including medical, dental, and vision, effective on the first of the month
  • 401(k) retirement plan with a generous company match
  • Generous time off accruals
  • Paid holidays
  • Mileage reimbursement
  • Tuition Reimbursement
  • Employee Referral Program
  • Bonus Eligible
  • Hospice Certification benefit and salary increase
Read More
Arrow Right

Embedded Transitional Care Manager

The Embedded Transitional Care Manager - RN (TCM-RN) plays a critical role in en...
Location
Location
United States , Indianapolis
Salary
Salary:
54095.00 - 116760.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • An active RN license within the state of practice in good standing
  • willingness to obtain cross-state licensure, as needed
  • Certified Case Manager (CCM) or equivalent case management certification required, or willingness to obtain within 12 months of hire
  • 2+ years’ experience in transitional nursing, discharge planning, nursing case management, or home health
  • experience in utilization management preferred
  • knowledge of Medicare/Medicaid and NCQA regulatory transitions of care criteria
  • exceptional communication skills and customer service orientation
  • innovative and independent problem-solving skills
  • ability to monitor and evaluate opportunities for cost-effective care options with high-quality outcomes
  • Spanish-speaking preferred but not required
Job Responsibility
Job Responsibility
  • Manage patients through transitions of care, either face to face in the facility or telephonically
  • advocate for the patient throughout the care continuum
  • identify opportunities for workflow improvements and partnerships
  • maintain real-time records of patient transitions
  • engage with physicians, case managers, and hospitalists
  • coordinate follow-up care, medication reconciliation, and discharge planning
  • collaborate with internal stakeholders and regional leaders on transitions initiatives
  • participate in training, documentation, tracking, and quality assurance
What we offer
What we offer
  • Mission-focused career
  • paid vacation and sick time
  • investment/retirement 401K match options
  • health insurance, vision, and dental benefits
  • affordable medical plan options
  • no-cost programs for health and wellness
  • tuition assistance
  • flexible schedules
  • family leave
  • dependent care resources
  • Fulltime
Read More
Arrow Right

Integrated Care Manager

Responsible for promoting continuity of care through a collaborative process tha...
Location
Location
United States , Phoenix
Salary
Salary:
Not provided
azblue.com Logo
Blue Cross Blue Shield of Arizona
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
  • Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
  • Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
  • Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications
  • Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).
Job Responsibility
Job Responsibility
  • Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan
  • Answer a diverse and high volume of health insurance related customer calls on a daily basis
  • Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests
  • Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
  • Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
  • Maintain complete and accurate records per department policy
  • Demonstrate ability to apply plan policies and procedures effectively
  • Fulltime
Read More
Arrow Right

Utilization Management RN

As a Utilization Management RN, you will be crucial in ensuring accurate and com...
Location
Location
United States , Bakersfield
Salary
Salary:
47.41 - 70.52 USD / Hour
americannursingcare.com Logo
American Nursing Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum of 3 years’ recent clinical experience
  • Graduate of an accredited RN Program
  • Clear and current CA Registered Nurse (RN) license
  • Knowledge of nursing theory and ability to apply or modify as appropriate
  • Knowledge of ICD-10, CPT, HCPCS coding, medical terminology and insurance benefits
  • Knowledge of legal and ethical considerations related to patient information, PHI and HIPAA regulations
Job Responsibility
Job Responsibility
  • Authorization Review: Proactively, concurrently, or retroactively reviewing referral authorization requests, gathering necessary information, and escalating to the Medical Director when needed
  • Compliance & Accuracy: Meeting turnaround times and accuracy standards
  • Provider Network: Ensuring authorized services are with contracted providers and coordinating with contracting for new agreements
  • Care Coordination: Identifying cases for additional case management and collaborating with internal departments to coordinate patient care
  • Quality & Cost-Effectiveness: Adhering strictly to utilization management policies to promote quality, cost-effective care
  • Denial Notice Composition: Drafting compliant, clear, and member-specific denial letters in accordance with federal, state, and health plan regulations, as well as NCQA standards
What we offer
What we offer
  • medical, prescription drug, dental, vision plans, life insurance, paid time off, tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, Health Spending Account (HSA), Long Term Disability, 401k retirement plan with a generous employer-match, Sick Leave
  • Fulltime
Read More
Arrow Right

Clinical Manager Hospice RN

Are you looking for a rewarding career in hospice? If so, we invite you to join ...
Location
Location
United States , Toms River
Salary
Salary:
115000.00 - 120000.00 USD / Year
amedisys.com Logo
Amedisys
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Associate or bachelors degree in nursing
  • One year of clinical RN experience in home health or hospice
  • One year of RN management experience
  • Current RN license, specific to the state(s) you are assigned to work
  • Current CPR certification
Job Responsibility
Job Responsibility
  • Supports, participates and works cooperatively with the director of staffing
  • Responsible for overall quality of patient care and clinical performance of nurses and aides
  • Organizes clinical operations for the care center
  • Reviews requests for services and determines patient eligibility/suitability for home care services
  • Works with intake in coordinating patient referrals and admissions
  • Oversees scheduling
  • Oversees payor verification and precertification requirements
  • Reviews documentation of other staff members and ensures missing, incomplete and/or untimely documentation issues are resolved
  • Assists clinicians in establishing immediate and long-term patient goals, setting priorities and developing Plan of Care (POC)
  • Regularly evaluates the needs of the patient and makes necessary revisions to the plan of care in collaboration with clinicians
What we offer
What we offer
  • A full benefits package with choice of affordable PPO or HSA medical plans
  • Paid time off
  • Up to $1,000 in free healthcare services paid by Amedisys yearly, when enrolled in an Amedisys HSA medical plan
  • Up to $500 in wellness rewards for completing activities during the year
  • Mental health support, including up to five free counseling sessions per year through the Amedisys Employee Assistance program
  • 401(k) with a company match
  • Family support with infertility treatment coverage, adoption reimbursement, paid parental and family caregiver leave
  • Fleet vehicle program (restrictions apply) and mileage reimbursement
  • Fulltime
Read More
Arrow Right

RN Case Manager Hospice

Are you looking for a rewarding career in hospice? If so, we invite you to join ...
Location
Location
United States , Hyannis
Salary
Salary:
93000.00 - 97000.00 USD / Year
amedisys.com Logo
Amedisys
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • One year of nursing experience
  • Current RN license, specific to the state(s) you are assigned to work
  • Current CPR certification
  • Valid driver's license, reliable transportation and liability insurance
Job Responsibility
Job Responsibility
  • Performs patient assessments and collaborates with the care team to develop and implement a plan of care
  • Makes referrals to other hospice care disciplines as needed or documents rationale for not doing so
  • Develops, prepares, and maintains individualized patient care progress records with accuracy, timeliness and according to care center policies
  • Records pain/symptom management changes/outcomes as appropriate
  • Teaches patients, families, and caregivers appropriate patient care techniques
  • Regularly communicates with clinical manager and care team
  • Performs on-call responsibilities and on-call services to patients/families as assigned
  • Other duties as assigned
What we offer
What we offer
  • $7,500 Sign-on Bonus
  • A full benefits package with choice of affordable PPO or HSA medical plans
  • Paid time off
  • Up to $1,000 in free healthcare services paid by Amedisys yearly, when enrolled in an Amedisys HSA medical plan
  • Up to $500 in wellness rewards for completing activities during the year
  • Mental health support, including up to five free counseling sessions per year through the Amedisys Employee Assistance program
  • 401(k) with a company match
  • Family support with infertility treatment coverage, adoption reimbursement, paid parental and family caregiver leave
  • Fleet vehicle program (restrictions apply) and mileage reimbursement
  • Fulltime
Read More
Arrow Right

RN Clinical Care Guide

The Clinical Care Guide (RN) will be a key contributor to our first-class care t...
Location
Location
United States , Scottsdale
Salary
Salary:
Not provided
azblue.com Logo
Blue Cross Blue Shield of Arizona
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Current state license to practice as a Registered Nurse
  • BLS certification
  • Electronic Medicare Records experience
  • Customer service orientation and experience
  • Strong communication skills across multiple modalities
  • Highly collaborative
  • Empathy and advocacy
  • Exceptional organizing skills, detail-orientation
  • Must be able to maintain confidentiality at all times
  • Active AZ fingerprint clearance card
Job Responsibility
Job Responsibility
  • Support members both in-person and virtually with real-time consultation, education, scheduling of specialist & diagnostic referral appointments, and follow-through + follow-up of those appointments
  • Play a critical role in the achievement of improved health outcomes and cost savings
  • Be an empathetic problem-solver and become the most visible partner to all patients
  • Clarify and explain referral for specialist and diagnostic service recommendations
  • Care for end to end process as needed, for referral or specialist services
  • Lead center in development and management of quality programs to include patient outreach to members in an effort to provide an elevated primary care experience with gaps in care or other clinical needs
  • Support members with chronic conditions by providing education, reminders, and other support
  • Handle the management and integration of office processes
  • Lead service and schedule requests on member’s behalf
  • Inform and equip Care Team with referral information and requirements
  • Fulltime
Read More
Arrow Right