RN Discharge Planner - CalAIM
About the role
Join a mission‑driven organization with a people‑first culture that offers excellent career growth opportunities. You will make a difference every day in the lives of underserved, overlooked, and vulnerable patients, working with autonomy in a warm team environment that emphasizes growth, training, and a commitment to “Always Do The Right Thing!”.
Responsibilities
- Coordinate clinical reviews, utilization management activities, and application of established care management criteria.
- Review clinical documentation, referrals, and pre‑certification requests to ensure compliance with department guidelines and regulatory requirements.
- Collaborate with medical directors, providers, site personnel, and care management teams to support patient care, discharge planning, and continuity of care.
- Monitor utilization data, claims reviews, and referral activity to ensure accuracy, appropriate coding, and effective cost management.
- Provide clinical oversight of reentry care plans and coordinate with managed care plans, community providers, and CalAIM partners to support successful care transitions.
Qualifications
Education: Unrestricted, current RN license in state of employment; BSN, CCM preferred.
Experience: Two (2) years’ clinical experience with discharge coordination; previous correctional/detention facility experience preferred.
Licenses/Certifications: Must maintain all certifications, educational requirements, licensing, etc. for RN license.
This position is available only to those who reside in the United States.
Benefits
- Comprehensive benefits including medical, dental, vision, paid time off, and 401(k)
- DailyPay – receive your money as you earn it
- Tuition assistance and dependent scholarships
- Employee Assistance Program (EAP) including free counseling and health coaching
- Company‑paid life insurance
- Tax‑free Health Spending Accounts (HSA)
- Wellness program featuring fitness memberships and product discounts
- Preferred banking partnership and discounted rates for home and auto loans