$91,249.60 - $120,910.40 / year
Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Reporting to the Supervisor, Non-Routine Placement, the Non-Routine Placement Nurse, RN is responsible for leading the coordination of complex and non-routine patient placements and transitions across the continuum of care. This role partners closely with hospitals, Independent Physician Associations (IPAs), skilled nursing facilities (SNFs), congregate living health facilities (CLHFs), and other post-acute providers to ensure timely, cost-effective, and high-quality care transitions. The Non-Routine Placement Nurse serves as a clinical and operational liaison, facilitating appropriate level-of-care determinations, removing placement barriers, and ensuring continuity of care for high-risk members. This position works closely with transitional care management, discharge planning, and readmission prevention teams by overseeing complex cases, ensuring regulatory compliance, and supporting optimal patient outcomes. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Key Responsibilities: Lead the coordination of complex or non-routine patient placements and discharges across facilities, service lines, and levels of care, ensuring timely and appropriate transitions. Serve as the primary point of contact for escalated or complex cases, ensuring timely follow-up, resolution, and communication of placement status and decisions. Lead the facilitation of transitions to higher or lower levels of care, including SNFs, CLHFs, and other post-acute settings, while supporting early discharge planning and readiness for transition. Act as a senior advisor and liaison between internal teams and external partners to ensure effective communication, coordination, and alignment on member care needs and treatment plans. Review and assess clinical information received from the ITC department to ensure appropriate placement based on acuity, service needs, and facility capabilities. Partner with case managers, social workers, providers, hospitals, IPAs, and post-acute partners using critical thinking to identify appropriate care pathways and resolve placement barriers. Monitor patient movement and throughput, proactively addressing delays and initiating escalation pathways when barriers or safety concerns arise. Review and acknowledge program referrals, assign cases to Non-Routine Placement Specialists (NRPS), and provide clinical oversight and direction on case progression. Provide education and guidance to case managers and Team Members on processes related to complex placements and discharge coordination. Maintain and update placement logs, referral tracking tools, and electronic medical records with accurate, timely, and complete documentation of all case activities. Document and track barriers, challenges, and interventions to support reporting, audits, and continuous quality improvement efforts. Ensure compliance with regulatory requirements and organizational standards, including CMS, HEDIS, CAHPS, and other quality measures. Participate in interdisciplinary huddles, throughput initiatives, and performance improvement activities aimed at enhancing efficiency and patient outcomes. Analyze trends, identify gaps in placement processes, and provide recommendations to improve workflows, service delivery, and care coordination. Continuously seek opportunities to improve operational efficiency through process improvements, innovation, and use of technology. Support outreach and relationship-building efforts with contracted providers and external partners to improve collaboration and participation in care initiatives. Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications: Education & Requirement Two (2) or more years in a health care delivery setting in Acute Care Hospital or Skilled Nursing Facility Experience in a health plan setting preferred Associate degree in Nursing from an accredited institution required Bachelor's degree in Nursing from an accredited institution preferred Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN required Key Qualifications Valid California Driver’s License preferred Strong knowledge and in-depth understanding of: Evidence based clinical criteria California Children Services (CCS) Evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies Understanding of and sensitivity to multi-cultural community Self-management philosophies and practices, especially as they relate to chronic medical conditions Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both Must have analytical skills Excellent communication, interpersonal and organizational skills Self-starter and a team player Time management, and problem-solving abilities Must have a high degree of patience Start your journey towards a thriving future with IEHP and apply TODAY ! Work Model Location: This position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday – Thursday onsite in Rancho Cucamonga, CA.) Pay Range: USD $91,249.60 - USD $120,910.40 /Yr. 
