Case Manager (RN) - Utilization Management
Chino Valley Medical Center•Chino, CA
•$43 - $58
About The Position
The Case Manager (RN) is responsible for quality and resource management for patients admitted to the facility, from admission through the continuum of health care management. The role advocates on behalf of patients, promotes cost containment, and provides leadership to integrate health care providers for seamless care delivery. The Case Manager performs holistic, comprehensive admission and concurrent medical-record reviews to evaluate medical necessity, intensity of service, and severity of illness, supporting quality, clinical, and cost-effective outcomes.
Requirements
- At least five years of work experience after graduating from an accredited school of nursing.
- Current state Registered Nurse license.
- At least one year of experience in case management, discharge planning, or nursing management.
- Basic to intermediate computer skills and knowledge.
Nice To Haves
- Five years of acute care nursing experience.
- CCM certification, or obtain it within one year.
- Knowledge of Milliman Criteria and InterQual Criteria.
- Current BCLS certificate.
Responsibilities
- Manage the quality and resources of patients admitted to the facility throughout the continuum of care.
- Advocate on behalf of patients and promote cost containment.
- Provide leadership to integrate health care providers and support seamless care delivery.
- Perform comprehensive admission and concurrent medical-record reviews for medical necessity, intensity of service, and severity of illness.
Benefits
- Paid time off
- 401K retirement plan
- Medical coverage
- Dental coverage
- Vision coverage
- Tuition reimbursement
- Voluntary benefit options
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
