RN Case Manager
Castro Valley, California
Eden Medical Center

Job Opportunity: Case Manager (Registered Nurse)

Location: Castro Valley, California
Employment Type: Travel/Contract
Contract Length: 13 weeks
Shift: Day shift, 5 days per week, 8 hours per day (8:00 AM – 4:30 PM)
Hours per Week: 40

Job Summary

As a Case Manager, you will coordinate care and manage transitions for acute inpatient RN patients throughout their hospital stay. You will collaborate with physicians, utilization managers, social workers, bedside nurses, and other interdisciplinary team members to ensure timely and appropriate patient care transitions, prevent unnecessary admissions or readmissions, and optimize resource utilization. The role includes care coordination, utilization management, and communication with patients, families, and community resources.

Key Responsibilities

• Review physician admission care plans and gather medical, psychosocial, and financial information to assess readmission risk.
• Lead healthcare team in developing cost-effective care coordination plans.
• Identify and report patient safety concerns.
• Oversee Case Management Assistants in post-acute care service planning.
• Ensure medical record documentation supports level of care (LOC) requirements.
• Collaborate with physicians to confirm documentation for LOC.
• Expedite transition planning for patients no longer requiring acute care.
• Monitor length of stay and manage outliers.
• Coordinate with financial counselors regarding inpatient stay denials.
• Deliver Medicare Important Message within required timeframes.
• Participate in patient rounds and interdisciplinary team meetings.
• Follow policies for Physician Advisor referrals and escalate LOC discussions as needed.
• Document consistently in electronic health records (EHR).
• Maintain knowledge of CMS, Joint Commission, and regulatory requirements related to transitions of care.
• Manage observation patients and collaborate on admission or transition decisions.
• Develop and communicate transition plans involving patients, families, payers, and community services.
• Screen for 30-day readmissions and address barriers to care progression.
• Identify patients with complex psychosocial issues and make appropriate referrals.
• Communicate with financial counselors regarding uninsured or underinsured patients.
• Ensure compliance with state and federal regulatory requirements for post-acute transfers.
• Participate actively in department operations and continuous improvement initiatives.
• Maintain professional relationships with healthcare team and community agencies.
• Demonstrate cultural sensitivity and professionalism in all interactions.

Required Qualifications

• Valid Registered Nurse (RN) license in California.
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN).
• Minimum of 1 year of acute care case management experience, with recent experience within the last year.
• Experience working in an inpatient setting.
• Basic Life Support (BLS) certification issued by the American Heart Association (AHA) or American Red Cross (ARC).