Field RN Case Manager Riverside, CA (Must live in the area)

$95,000 - $105,000/Yr

Scm Associates - Riverside, CA

Full-time - Mid Level

Onsite - Riverside, CA

Professional, Scientific, and Technical Services

About the position

The RN Case Manager is responsible for identifying, assessing, planning, coordinating, implementing, monitoring, and evaluating case management services for individuals. The role aims to ensure quality and cost-effective outcomes through collaboration with clients, families, physicians, and healthcare teams. This position requires fieldwork, including visits to hospitals, doctors' offices, and client homes, and is not fully remote.

Responsibilities

• Processes cases utilizing the outcome management model and tools.
• Obtains written authorization for case management services and release of information.
• Assesses the client/family to identify strengths, resources, problems, and needs.
• Develops a plan of care through interdisciplinary collaboration.
• Identifies, secures, and coordinates services to implement the plan.
• Monitors services for appropriateness and reports to TPAs and insurance carriers.
• Evaluates client progress and modifies the plan as necessary.
• Provides ongoing instruction to clients and families regarding care.
• Promotes self-advocacy skills for clients and families.
• Coordinates with payers for authorization of payment.
• Reports outcomes encompassing clinical, functional, financial, and customer satisfaction areas.
• Demonstrates effective verbal and written communication in all situations.
• Identifies situations that may expose legal liability or indicate poor quality care.
• Travels frequently to patient appointments.

Requirements

• Registered Nurse (RN) license required.
• Bachelor of Science in Nursing (BSN) preferred.
• Certified Case Manager (CCM) preferred.
• Two years of full-time managed care or hospital-based case management experience required.
• Ability to read and interpret medical information and professional journals.
• Ability to present information and respond to questions effectively.
• Knowledge of database software and Microsoft Word.

Nice-to-haves

• Experience in supply chain management.
• Strong communication skills.
• Detail-oriented with the ability to prioritize projects.

Benefits

• Competitive salary between $95,000 - $105,000 per year.
• Flexible work environment with home office setup.