Registered Nurse III MC/CHC Per Diem (Case Manager) - RUHS UR Case Management

Full Job Description

We are seeking an experienced Registered Nurse (RN) Case Manager to support all areas of Case Management, including the Emergency Department (ED), Transfer Center, Inpatient Units, and Utilization Management (UM). This role is responsible for coordinating patient care across the continuum, ensuring appropriate level of care, optimizing resource utilization, and supporting safe, timely discharges.

The essential job duties of this position include, but are not limited to the following:

• Provide comprehensive nursing care to patients in accordance with established standards of practice, policies, and procedures.
• Assess, plan, implement, and evaluate individualized patient care plans.
• Perform utilization review and case management activities, including evaluating continued stay criteria and level of care appropriateness.
• Coordinate discharge planning, identify post-discharge needs, and facilitate referrals to appropriate community and ancillary services.
• Administer medications and treatments safely while monitoring patient response and documenting outcomes accurately.
• Maintain complete, accurate, and timely clinical documentation in compliance with regulatory and payor requirements.
• Collaborate effectively with physicians, interdisciplinary teams, patients, and families to ensure quality patient outcomes.
• Ensure compliance with federal, state, and local regulations governing nursing practice and reimbursement standards.
• Educate patients and families regarding treatment plans, medications, and follow-up care.

The ideal candidate will have strong acute hospital Case Management and Utilization Management experience, with proven expertise using InterQual criteria to support medical necessity reviews and authorization process.

License and Certifications Required:

• A valid and current Registered Nurse license issued by the State of CA
• Basic Life Support (BLS) certification issued by the American Heart Association
• Case Management Certification (CCM) is highly preferred

Work Schedule:
9/80 - Monday to Friday
Hours: 8:00 am to 5:30 pm

Meet the Team!At Riverside University Health System Medical Center, nursing is more than a job, it’s an opportunity to make a real difference in a vibrant and diverse community.

Nationally recognized for its forward-thinking and innovative approach to patient care, RUHS Medical Center is also a proud teaching hospital and one of the top employers in the region.

Our 439-bed facility is a designated Level I Trauma Center, Primary Stroke Center, and home to the region’s only Pediatric Intensive Care Unit (PICU). Here, you’ll gain valuable experience across a wide range of specialties, including trauma care, stroke, pediatrics, and critical care.

We are committed to your professional growth, offering continuous education, training, and career development programs in a collaborative, supportive, and rewarding environment.

Whether you’re an experienced nurse or just starting your career, RUHS Medical Center provides unparalleled opportunities to learn, grow, and make a meaningful impact.

Could you see yourself making a difference here?
Discover more about RUHS Medical Center at www.ruhealth.org

Requirements

• Assess, plan, organize, and provide nursing care to assigned patients in accordance with physician instruction ; make preliminary observations of patients and prepare patients for medical treatment.

• Assist physicians in administering treatments and in performing medical examinations, diagnostic tests and surgical operations.

• Administer prescribed treatment and medications, including dispensing, as ordered to patients; chart treatment of patients; record and report significant changes in condition and general progress of patients.

• Counsel and advise patients, families and significant others regarding special medical problems and/or proper healthcare methods.

• Prepare and maintain concise and complete records and reports; instruct patients in carrying out physician's orders; transcribe physician's orders to working records.

• Provide orientation and training to new staff, residents, medical students, Regional Occupational Program (ROP) participants and nursing students.

• Participate in quality assurance reviews; act as a team leader or relief charge nurse.

• Assign and monitor, the work of subordinate nursing personnel; participate in committee activities; identify staff training needs.

• Triage patients by reviewing admission charts and merging patients into the appropriate patient assignment or clinic flow when appropriate.

• Testify in court as to client's mental and physical condition.

• Coordinate and monitor patients through the hospitalization process utilizing physicians, primary care nurses and third-party payors to maintain quality care and fiscal responsibility.

• Review the post hospital care plan with the patient,/family establishing a contact regarding timeframes and responsibilities; follow care plan through patient discharge.

Qualifications

Registered Nurse III MC/CHC Per Diem:
Rate: $77.1585 per hour

Education: Successful completion of the education required to obtain a valid license to practice as a Registered Nurse in the State of California.

Experience: Three years of full time experience as a Registered Nurse in an acute care facility, mental health facility, or community health agency with references and evaluations to show appropriate skill level. (A bachelor's degree from an accredited college or university in nursing or national certification in a nursing specialty may be considered as a substitution for one year of the required experience. A master's degree from an accredited college or university in nursing may be considered as a substitution for two years of the required experience.)

Knowledge of: Current principles, techniques and procedures used in professional nursing; medical terminology and patient care routine appropriate to clinical setting; medical instruments and equipment; the uses and effects of medicines and narcotics; community resources available to provide patient care and follow-up; federal, state and local laws and regulations governing professional aspects of nursing; identification of potential discharge needs; payor source documentation requirements and governmental regulations affecting reimbursement.

Ability to: Perform the full range of nursing duties and responsibilities in a patient care setting; plan and organize nursing plans for patients; prepare and maintain concise and complete records and reports; establish and maintain effective working relationships with physicians, patients and co-workers; secure the cooperation of employees to work effectively together; assist in the instruction of entry-level nurses and ancillary personnel; keep abreast of developments in area of nursing specialization; evaluate the medical records of hospital admissions; provide recommendations regarding continued stay necessity; identify discharge needs.

Other Requirements
License: Must possess and maintain a current valid license to practice as a Registered Nurse in the State of California.

Possession and maintenance of a current valid Basic Life Support (BLS) certificate issued by the American Heart Association.

Possession of a valid California Driver's License may be required.

Additional Information

Application Status
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Go to www.RC-HR.com, click on "Careers," click on "County Job Openings," and click on "Subscribe to Job Alerts" icon.

For questions regarding this recruitment,
Please contact Lisette Jimenez at 951-955-5561 or lijimenez@rivco.org. Please allow 1-2 business days for a response to general inquiries.