RN Case Manager

Base pay range

$50.00/hr - $55.00/hr

The Registered Nurse Case Manager plays a critical role in California Children’s Services (CCS), supporting children and young adults from birth through 21 years of age with complex medical conditions. This position focuses on medical case review, eligibility determination, and coordination of services to ensure access to appropriate care.

• Review and analyze medical records and clinical documentation for pediatric patients with complex diagnoses, including but not limited to cancer, cerebral palsy, and chronic or severe medical conditions
• Determine medical eligibility for California Children’s Services programs
• Process authorizations and denials based on clinical criteria and program guidelines
• Conduct thorough medical reviews to ensure compliance with CCS and public health standards
• Manage a caseload of approximately 550 cases, completing an average of 10–15 medical reviews per day
• Perform the majority of work on the computer, utilizing electronic systems and medical records
• Collaborate with healthcare providers, internal teams, and program staff to support continuity of care

• Active and unrestricted Registered Nurse (RN) license
• Experience in case management or pediatric nursing
• Experience reviewing medical documentation, authorizations, or utilization management–type work
• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)
• 401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)
• Short Term Disability Insurance
• Term Life Insurance Plan

Not Applicable

Full-time

Health Care Provider

Hospitals and Health Care

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.