RN - Case Manager - BSN - AS Utilization Management - Full Time - 8 Hour - Days
Company: John Muir Health
Location: Walnut Creek
Posted on: October 30, 2025
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Job Description:
Job Description: The role of the inpatient case manager is one
of patient advocate of appropriate utilization of resources. The
inpatient case manager applies the process of assessment, planning,
implementation, monitoring, evaluation and coordination of care to
meet the patient's health care needs through hospitalization and
transition back to the community and does this in coordination with
the interdisciplinary health team. The RN Case Manager is expected
to function within the full scope of the nursing practice with
specialized focus on care coordination, compliance, transition
management, education, and utilization management. Education:
Bachelor's Degree Accredited School of Nursing Required Experience:
3 years Nursing - Medical/Surgical Preferred or 3 years Nursing -
Critical Care Preferred 2 years Care Coordination - Case Management
Preferred or Equivalent Work Experience Certifications/Licensures:
RN Registered Nursing - California Board of Nursing Required BLS
Basic Life Support - American Heart Association Required ACM
Accredited Case Manager - ACMA American Case Management Association
or CCM Certified Case Manager - CCMC Commission for Case Manager
Certification Strongly Preferred Skills: Strong written and verbal
communication skills. Effectively motivates teams. Strong knowledge
of Medicare and Medi-Cal guidelines and benefit resources as
applicable to hospitalization and transition planning. Working know
ledge of common diagnoses and procedures and the impact this w ill
have to patients/families and their ability to manage their care
outside of the hospital. Specialized know ledge may be required for
certain areas of practice. Knowledge of individual and family
development over the life span, and the influences of cultural and
spiritual values in health care. General knowledge of commercial
coverage plans and usually covered benefits. Strong understanding
of various reimbursement models and impact to care delivery,
patient management and reimbursements such as ACOs, DRGs, Full
Risk, etc. Strong understanding of the criteria, rules and
regulations around Inpatient, Observation and Outpatient levels of
patient management. Strong know ledge of geriatrics and the impact
to health and function in the aged as w ell as a working know ledge
of chronic/progressive disease states such as CHF, COPD, Diabetes
and End Stage Renal Disease, etc. Clear understanding of the role
of the inpatient Social Worker and Palliative Care Resources.
Ability to plan, organize, manage time and prioritize work in
collaboration with others. Ability to work independently and as a
part of a multidisciplinary team. Effective problem solving and
conflict resolution skills. Ability to work respectfully and
creatively with clients of diverse functional abilities, social,
economic, and cultural backgrounds to support both client autonomy
and client safety. Leadership skills to delegate and provide
direction/guidance to staff and hold others accountable. Able to
learn and work in a variety of computer programs, including EPIC,
Allscripts, InterQual, and Microsoft Outlook. work shift: 5 days
one week/4 days the next in a 2-week pay period. Set rotation every
Sunday-Wednesday/Thursday. Work Shift: 08.0 - 08:00 - 16:30 No
Waive (United States of America) Pay Range: $84.77 - $115.51 Hourly
Offer amounts are based on demonstrated/relevant experience and/or
licensure. Pay will be adjusted to the local market if hired
outside of the Bay Area . Note: Positions at JMH which are exempt
(not eligible for overtime) under the level of Manager are listed
as hourly for compensation purposes on this posting. The work shift
will contain the word 'exempt' on it. Scheduled Weekly Hours:
36
Keywords: John Muir Health, Walnut Creek , RN - Case Manager - BSN - AS Utilization Management - Full Time - 8 Hour - Days, Healthcare , Walnut Creek, California
