Nurse Case Manager, Per Diem

About the role

Provides case management services to a caseload of low- and medium-risk patients. Develops and implements client-focused case management plans in collaboration with healthcare teams, patients, and caregivers, ensuring alignment with regulatory, accreditation, and regional guidelines. Coordinates resources, services, and referrals to assure continuity and quality of care, while monitoring patient progress and addressing barriers to treatment goals.

Responsibilities

• Interviews patients and caregivers to evaluate needs, goals, and current services.
• Determines initial eligibility, benefits, and education for all admissions, assessing medical necessity and required level of care to inform physicians.
• Reviews and enters authorization data (e.g., admitting/principal diagnoses, bed type(s), and disposition data) for accuracy and documents inaccuracies.
• Develops a client-focused case management plan in collaboration with the healthcare team, patient, and caregivers, ensuring consistency with regulatory and accreditation guidelines.
• Assists patients with gaining access to care based on their needs, making referrals to internal and external resources as appropriate.
• Coordinates resources and services to assure continuity and quality of care, attending case management rounds with clinicians as needed.
• Assesses patient progress toward treatment milestones and care plan goals, identifying and addressing barriers to achieving goals.
• Verifies that all services remain consistent with established guidelines and standards.
• Documents patient cases in all medical files and reviews benefits/services available to patients and caregivers.
• Identifies patients ready for disposition planning and develops a comprehensive disposition plan in collaboration with the patient, caregivers, and healthcare providers.
• Obtains authorizations as needed for patient services and attends professional seminars, workshops, and educational programs.
• Monitors operational team data and key metrics, making suggestions for improvement and ensuring adherence to policies and regulatory requirements.
• Serves as a liaison between internal and external care providers, leveraging knowledge of patient cases to act as a resource for physicians, health plan administrators, and contracted vendors.
• Supports cross-functional collaboration, escalates issues or risks, and communicates progress and information effectively.

Qualifications

Minimum Qualifications:

• Bachelor’s degree in Nursing or related field AND minimum three (3) years of experience in nursing, case management, or a directly related field.
• Registered Professional Nurse License (Georgia) required at hire.

Preferred Qualifications:

• Certified Case Manager (CCM) in the state where care is provided.
• Basic Life Support (BLS) Certification.

Skills

Core Skills:

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry Knowledge
• Influencing Others
• Integrity
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Teamwork
• Topic-Specific Communication

Functional Skills:

• Acts with Compassion
• Business Relationship Management
• Community Health Knowledge
• Company Representation
• Confidentiality
• Health Care Compliance
• Maintain Files and Records
• Managing Diverse Relationships
• Member Service
• Patient Safety
• Quality Assurance and Effectiveness
• Relationship Building
• Written Communication

Pay

$47.40 - $61.29 per hour. Kaiser Permanente strives to offer a market-competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of the total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.

Schedule

• Shift: Day
• Workdays: Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday
• Working Hours: 08:30 AM - 05:00 PM
• Job Schedule: Call-in/On-Call
• Travel: Yes, 10% of the time
• Work Setting: Onsite