Utilization Care Manager Jobs Near Me

Registered Nurse (RN) Care Manager
Role Summary:
The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient-centered care across a variety of settings, including clinics, centers, and patient homes. This position is responsible for assessing patient needs, developing and implementing care plans, coordinating services, and evaluating outcomes to ensure holistic and high-quality healthcare delivery. Working collaboratively with a dedicated team, the RN Care Manager helps patients achieve optimal health, independence, and quality of life.
Key Duties and Responsibilities:

• Deliver compassionate, high-quality nursing care in the clinic, center, contracted facilities, and patients’ homes according to individualized care plans and regulatory standards.

• Participate in a 24/7 on-call rotation for patient triage and support.

• Assess, plan, and coordinate home care services, ensuring that nursing needs are identified and met appropriately.

• Monitor and manage both acute and chronic patient conditions in various settings, promoting continuity of care and supporting transitions between home, assisted living, nursing, or hospital care as needed.

• Facilitate communication and collaboration among providers, obtaining specialist reports, lab results, and documentation to ensure seamless patient care.

• Perform monthly medication reconciliation for assigned patients, ensuring accuracy and adherence, and promptly address discrepancies.

• Communicate test results and updates to patients in a timely and compassionate manner.

• Complete accurate and timely nursing assessments in accordance with policy and regulatory requirements.

• Implement care plan interventions and educate patients, caregivers, and families on self-care, medication management, healthy living, and safety practices.

• Collaborate with patients, families, caregivers, and the team to regularly review and revise care goals and approaches.

• Participate actively in team meetings, quality improvement projects, and utilization review discussions.

• Evaluate and delegate tasks to CNAs and Home Care Aides, ensuring competency and compliance with care plans.

• Support and mentor fellow team members, contributing to an environment of learning, respect, and collaboration.

• Protect patient privacy, maintain confidentiality, and adhere to safety and infection control protocols.

• Uphold all organizational policies and promote a culture of excellence and integrity in every aspect of care delivery.

• Perform additional duties as assigned or required.

Required Qualifications:

• Active, unrestricted Registered Nurse (RN) license in the applicable state.

• Bachelor of Science in Nursing (BSN) preferred.

• Basic Life Support (BLS) certification (must be obtained within 90 days of employment).

• Minimum of one year of RN experience.

• Reliable transportation, valid driver’s license, and current auto insurance.

• Ability to meet health and immunization requirements for direct patient care.

• Successful completion of a comprehensive background check, including criminal history, license verification, and drug screening.

Desired Qualifications:

• Experience working with elderly or medically complex populations preferred (training provided if not present).

• Background in home care, long-term care, or managed care settings.

• Strong understanding of person-centered care, patient advocacy, and self-determination.

• Familiarity with managed care environments, quality metrics, and cost-effective care models.

• Excellent communication, teamwork, and problem-solving skills.

• Proficiency with Electronic Medical Records (EMR) systems and Microsoft Office applications (Outlook, Word, Excel, PowerPoint).

• A commitment to continuous learning, quality improvement, and evidence-based practice.

• Flexibility, empathy, and the ability to thrive in a fast-paced, collaborative healthcare environment.

Work Environment and Physical Requirements:

• Work may take place in clinics, community centers, contracted facilities, or patient homes.

• Moderate noise levels and temperature-controlled environments.

• Manual dexterity, hand-eye coordination, and ability to lift up to 30 pounds using proper body mechanics.

• Ability to communicate effectively in person and by telephone.

• May involve exposure to typical healthcare-related conditions including bodily fluids, infectious diseases, and medical equipment.

• Reasonable accommodations will be made for individuals with disabilities in accordance with ADA guidelines.

Work Type: On-site with travel to patient homes as needed; some hybrid flexibility may be available depending on program needs.

About the Organization:
This role is part of a mission-driven healthcare organization dedicated to improving the lives of older adults and individuals with complex medical needs. The team fosters a compassionate, inclusive, and collaborative culture, where nurses are empowered to lead, innovate, and make a lasting difference in patients’ lives.
If you're interested, please reply to this advertisement or directly email your resume to me at DSalgado@teemagroup.com or by calling/texting (949) 295-5951.
I strive to reply within 48 hours. Looking forward to connecting with you soon. Thank you!