No Specialty – RN

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Job ID: 884227

Estimated Weekly Gross: $1,813.63

Job Title

Registered Nurse – Case Management / Utilization Management

Location

Roseville, CA

Schedule / Job Type

Contract | Full-Time | Day Shift | Monday–Friday | Onsite

Key Responsibilities

• Manage the development, implementation, and evaluation of care management service lines, including in-patient and out-patient management, care integration, case management, utilization review, and care planning
• Partner with physician advisors, claims departments, and data management teams to establish safeguards, processes, and expected outcomes for the member population
• Perform and/or coordinate preventative care, wellness, and nutritional counseling for members
• Collaborate with physicians, staff, and service line leadership on quality and performance improvement activities related to resource utilization, patient flow, and capacity management
• Ensure members’ medical conditions meet medical necessity criteria and communicate changes that may affect discharge planning
• Coach patients and members through their healthcare journey with strong communication and relationship-building skills

Required Qualifications

• Active Registered Nurse (RN) licensure in the state of practice
• Current BLS certification
• Minimum of two years of recent nursing experience
• Strong communication skills with demonstrated experience coaching patients or members through their healthcare journey

Preferred Experience / Skills

• Bachelor’s Degree in Nursing (BSN)
• Certified Case Manager (CCM) certification
• 5–10 years of acute and ancillary experience across multiple care modalities
• Prior experience working within a health plan setting focused on utilization management and case management activities

Why Join Us

• Join a collaborative, mission-driven environment with access to a modern, well-being-focused campus designed to inspire your best work
• Contribute to meaningful, whole-person care management that directly impacts member health outcomes and quality of life

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