Case Manager
Roseville, CA
Care Career
5x8 hrs, Days
Referral Bonus

Job Breakdown – Case Management RN

Job ID: 62548850 Specialty: Acute Care Case Management RN Shift: Day shift, 8:00 AM – 4:30 PM Schedule: Monday–Friday, 5 × 8-hour shifts Weekends: Not required On-call: Not required Required Experience: Minimum 2 years  

1. Required Qualifications

• Active California RN license.
• Minimum 2 years of nursing experience.
• Must have experience in acute-care case management in California.
• Kaiser experience is excluded for this requirement.

Important: The following experience types do not qualify:

• Outpatient case management.
• Home health case management.
• Health plan case management.

The candidate must have actual acute-care hospital case management experience in California.

2. Required Skills and Knowledge

Candidates should have knowledge of:

• Acute-care case management in a managed-care environment.
• Utilization Review (UR).
• Levels of care and observation status.
• Healthcare reimbursement systems, including HMO, PPO, PPS, and CMS.
• Post-acute care options and regulatory compliance.
• CMS, Title 22, CHA Consent Manual, CDPH, and The Joint Commission (TJC) requirements.
• Patient discharge planning and care coordination.

Preferred knowledge:

• Coding and DRG assignment processes.
• Value-based reimbursement and alternative payment systems.

3. Job Responsibilities

• Coordinate care for patients in an acute-care hospital.
• Review utilization and appropriate levels of care.
• Support discharge planning and transitions to post-acute care.
• Communicate with physicians, nurses, patients, families, payers, and other healthcare partners.
• Promote collaboration across the multidisciplinary team.
• Maintain organized workflows in a high-volume environment.
• Support quality patient care and a positive patient experience.

4. Work Schedule

• Monday–Friday, 8:00 AM–4:30 PM.
• No weekend shifts.
• No on-call requirement.
• Local candidates are accepted at the local rate.
• A 50-mile radius rule applies; confirm the applicable local classification and rate.

5. Submission Requirements

• Valid California RN license.
• Nursys verification uploaded within the previous 2 weeks.
• Two references obtained within the past year.
• Former manager names included on the application.
• Applicable certifications uploaded with valid expiration dates.
• Any background or license issues disclosed with supporting documentation for facility HR review.
• All requested time off (RTO) included at submission.

6. Compliance Requirements

• Maximum RTO: 7 days per contract.
• Only one major holiday request may be submitted per contract.
• Onboarding labs must be completed within 3–5 days of contract signing.
• A verifiable 7-year work history is required.
• All compliance documents are due 10 days before the start date.
• Online modules are generally non-billable for the first 16 NBO hours; additional time beyond those 16 hours is billable according to the posting.