Case Manager (RN) - Utilization Management

Prime Healthcare•Chino, CA

17h•Onsite

About The Position

Chino Valley Medical Center is a 112-bed community hospital established in 1972 and centrally located in Southern California’s Chino Valley. A nine-time recipient of the Healthgrades Patient Safety Excellence Award (2014-2022), Chino Valley Medical Center has been recognized nationally for its quality, including as among the 100 Great Community Hospitals by Becker’s Hospital Review in 2018 and as among the 100 Top Hospitals by IBM Watson Health. Chino Valley Medical Center is committed to serving the community’s health care needs with top-rated emergency care as well as senior services, orthopedics, surgical services and more. Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Chino Valley Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Chino Valley Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. 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 ensure 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.

Requirements

Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
At least one year experience in case management, discharge planning or nursing management
Experience and knowledge in basic to intermediate computer skills.

Nice To Haves

Five years of acute care nursing experience.
CCM or obtained within 1year
Knowledge of Milliman Criteria and InterQual Criteria preferred.
Current BCLS certificate, 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.
Perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.