Travel Emergency Department RN Case Manager
Company: NorthBay Healthcare Group - 1200 B. Gale Wilson Bo
Location: Vacaville
Posted on: January 9, 2026
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Job Description:
Job Description Certification Details - BLS - California state
Registered Nurse (RN) license Job Details - The Emergency
Department Case Manager Weekend (EDCM) is responsible for
assessing, planning, implementing, monitoring and evaluating
options and services to create an individualized care plan for
patients in the Emergency Department (ED) and across the continuum
of care. - Ensures timely transition of patients to the optimal
level of care, makes recommendations to the Interdisciplinary Care
Team, and coordinates post-ED care by collaborating with patients,
families, physicians, nursing staff, and other healthcare
providers. - Utilizes clinical knowledge, communication,
problem-solving, conflict resolution, assessment, organization, and
time management skills to drive optimal patient outcomes while
considering financial and health plan resources. - Monitors ED
utilization trends, ensures connection with appropriate resources,
documents in Cerner, verifies medical necessity and insurance
compatibility, and uses MCG criteria to assess care levels. -
Coordinates facility transfers, ensures hospitalizations are
appropriate and contracted, adheres to departmental policies, and
provides support to inpatient colleagues as needed. - Reports to
the Inpatient Case Management Supervisor or designee. - Applies MCG
criteria to monitor appropriateness of admissions, level of care,
and continued stays. - Documents findings and interventions in
Cerner based on departmental standards. - Manages patient care
through the ED and healthcare systems based on individual needs. -
Collaborates with physicians, Social Services, and healthcare
providers for care plan changes. - Advocates for patients and
families throughout the care episode. - Remains available to
patients/families to facilitate communication among providers. -
Develops individualized comprehensive care plans with physicians,
Social Services, and the interdisciplinary team. - Continuously
assesses and reassesses patients, updating discharge plans as
needed. - Transitions patients to the next level of care and
involves appropriate outpatient resources. - Transfers case
management function using SBARQ format when needed. - Coordinates
patient transfers using health plan knowledge and MCG criteria. -
Initiates and facilitates outpatient referrals to prevent
inappropriate hospital admissions. - Applies knowledge of cultural,
psycho/social, developmental, and age-specific factors. - Maintains
knowledge of federal, state, and local regulations. - Acts as a
resource for physicians and staff on utilization management and
care options. - Communicates with health plans and acts as a
liaison regarding insurance and discharge planning. - Identifies
high-risk patients and communicates with Readmissions Case Manager.
- Evaluates case management impact on outcomes and develops
strategies for improvement. - Utilizes problem-solving and conflict
resolution to develop effective care plans. - Initiates regulatory
forms and letters to ensure compliance. - Completes timely
assessments, documentation, and reports. - Interacts with the
healthcare team to ensure appropriate post-ED/hospital plans. -
Informs patients/families about financial implications related to
care plans. - Maintains confidentiality of patient and electronic
data as per regulations. - Keeps current on organizational
policies, regulations, and legislative changes. - Documents
utilization data and discharge planning in Cerner. - Refers
patients using high-risk screening criteria to appropriate
follow-up services. - Hands off information to inpatient case
managers using SBARQ format. Job Requirements - Basic knowledge of
personal computers and word processing software. - Good keyboard
skills. - Ability to enter and retrieve data from relevant computer
systems. - Competence in Microsoft Office programs including
Outlook and Word. - Knowledge of Medicare rules and regulations and
Conditions of Participation. - Knowledge of Joint Commission and
Department of Health organizational standards. - Knowledge of acute
care, home care, subacute care, long-term care, hospice,
rehabilitation options, and community resources. - Understanding of
medical necessity guidelines and quality assurance processes. -
Ability to determine positive outcomes and understand healthcare
trends and best practices. - Familiarity with management tools and
related healthcare literature. - Minimum of Three (3) years of
acute clinical nursing experience. - Experience with MCG
(preferred). - Experience with Cerner (preferred). - Experience
with PowerPoint (preferred). - Emergency Department experience
(preferred). - Minimum of Two (2) years of case management
experience (preferred). - Graduate of an accredited nursing school
or college. - Bachelor of Science in Nursing (BSN). - Master of
Science in Nursing (MSN) (preferred). - Current California state
Registered Nurse (RN) license. Schedule Information - Weekend shift
for Emergency Department Case Manager. Unit Specific Information -
Emergency Department
Keywords: NorthBay Healthcare Group - 1200 B. Gale Wilson Bo, Vacaville , Travel Emergency Department RN Case Manager, Healthcare , Vacaville, California
