Case Manager (RN) - Utilization Management
Chino Valley Medical Center•Chino, CA
•$43 - $58
About The Position
The Case Manager is responsible for quality and resource management for patients admitted to the facility, from admission and throughout the continuum of health care management. The role advocates for patients, promotes cost containment, and demonstrates leadership in integrating health care providers to support seamless care delivery. The work is designed to help achieve quality, clinical, and cost-effective outcomes through holistic, comprehensive admission and concurrent medical-record reviews for medical necessity, intensity of service, and severity of illness.
Requirements
- A BSW or another bachelor's degree in a related field.
- At least one year of experience in case management, discharge planning, or nursing management.
- Experience and knowledge in basic to intermediate computer skills.
Nice To Haves
- At least five years of acute care experience.
- CCM certification, or ability to obtain it within one year.
- Current BCLS certificate.
- Knowledge of Milliman Criteria and InterQual Criteria.
Responsibilities
- Manage quality and resources for patients from admission throughout the continuum of health care management.
- Advocate on behalf of patients and promote cost containment.
- Integrate health care providers to support seamless delivery of care.
- Conduct holistic and comprehensive admission and concurrent reviews of medical records 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
