Case Manager RN

ahmchealth· Case Management
Apply Now ↗
📍 Anaheim, CA, USOTHER💰 USD 39–49/yr

About this role

Overview

The RN Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, concurrent stay and readiness for discharge.  She/he assures correct level of care: critical, telemetry, acute, observation, for all patients.  The Case Manager provides an efficient, coordinated approach to clinical management, with an emphasis on discharge planning, care coordination and utilization management activities for select patient populations across the continuum of programs and services at AHMC.  The essential functions of the RN Case Manager require constant collaboration with the Social Workers, Nursing staff, Financial Counselors, Medical Staff to coordinate the care of patients in a proactive manner. 

 

Responsibilities

The position requires the full understanding and active participation in fulfilling the mission of AHMC- Anaheim Regional Medical Center.  It is expected that the employee demonstrate behavior consistent with the core values.  The employee shall support AHMC- Anaheim Regional Medical Center strategic plan and goals and direction of the performance improvement plan.

Qualifications

  • 2 years Utilization Management/Case Management experience preferred in acute care setting.
  • Working knowledge of Interqual, Intensity of Service/Severity of Illness criteria.
  • Working knowledge of Title XVII and Title XIX.
  • Working knowledge of reimbursement related to Medicare, Medi-Cal, Capitation, and Managed Care is required.
  • Ability to negotiate orders with the physicians in order to assign alternate levels of care.
  • Working knowledge of community resources.
  • Working knowledge of methods to resolve patient needs such as discharge planning, Home Health, DME and SNF’s.
  • Ability to case manage smoothly and increase patient/physician satisfaction while staying within guidelines.
  • Ability to track outcomes and report findings.
  • Able to problem solve effectively.
  • Ability to use clinical knowledge to identify potential quality issues, delays in service, post-acute care needs required.
  • Must have excellent oral and written communication, interpersonal, problem-solving, conflict resolution, presentation, time management, and positive personal influence and negotiation skills.
  • Must have strong clinical assessment and critical thinking skills necessary to provide utilization review/discharge planning services appropriate to patients with complex medical, emotional and social needs.
  • Must have the ability to work in a high volume caseload environment and deal effectively with rapidly changing priorities.
  • Excellent computer skills with word, excel and power point.

    •  

    Frequently Asked Questions

    What is the salary for the Case Manager RN role at ahmchealth?
    The listed salary for this Case Manager RN position at ahmchealth is USD 39–49/yr. This is an OTHER role.
    Where is the Case Manager RN position at ahmchealth located?
    This Case Manager RN role at ahmchealth is based in Anaheim, CA, US. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
    Is the Case Manager RN role at ahmchealth full-time or part-time?
    This is listed as a OTHER position. It is posted as a Case Manager RN role in the Case Management department at ahmchealth.
    Which team or department does the Case Manager RN at ahmchealth belong to?
    This Case Manager RN position is part of the Case Management department at ahmchealth. See the full job description for more information about the team structure and responsibilities.
    How do I apply for the Case Manager RN position at ahmchealth?
    Click the "Apply Now" button on this page. You will be redirected to ahmchealth's official application portal hosted on icims where you can submit your application directly.
    When was the Case Manager RN job at ahmchealth posted?
    This Case Manager RN position at ahmchealth was posted on Mar 26, 2026. Apply as soon as possible — early applications are often reviewed first.
    Case Manager RN
    ahmchealth · 💰 USD 39–49/yr
    Apply for this role ↗

    You'll be redirected to ahmchealth's official application page on icims.