Case Manager (RN) - Utilization Management

Mission Regional Medical center•Montclair, CA

64d•$42 - $56

About The Position

Montclair Hospital Medical Center is a 106-bed acute care, not-for-profit community hospital, received the "100 Top Hospital" in the nation award from IBM Watson Health, the Patient Safety Excellence award from Healthgrades, and the Women's Choice Award for America's Best Emergency Care. For more information visit Montclair-hospital.org At Montclair Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community! Why Prime Healthcare? Montclair Hospital Medical Center is a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. This is a Fast-paced work environment in which you can take pride in serving an underserved community. Come Join a Team of Dedicated Healthcare Workers!!! Montclair Hospital Medical Center is nationally recognized, locally preferred, and community focused.

Requirements

BSW or other Bachelor degree in a related field.
At least one year experience in case management, discharge planning or nursing management
CCM or obtained within 6 months of hire.
Experience and knowledge in basic to intermediate computer skills.

Nice To Haves

Minimum 5 years of acute care experience preferred.
At least one-year experience in case management, discharge planning or management, preferred.
Current BCLS certificate preferred.
Knowledge of Milliman Criteria and InterQual Criteria preferred.

Responsibilities

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.
Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care.
The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.