Case Manager - Utilization Management

Prime Healthcare•Anaheim, CA

2d•Onsite

About The Position

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! West Anaheim 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. Founded in 1964, West Anaheim Medical Center is a 219-bed acute-care hospital dedicated to providing the community with high-quality, compassionate healthcare. Key services include general medical and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more information visit www.westanaheimmedctr.com.

Requirements

BSW or other bachelor's degree in a related field.
At least one year experience in case management, discharge planning or nursing management; or Experience and knowledge in basic to intermediate computer skills.

Nice To Haves

Minimum 5 years of acute care experience preferred.
CCM or obtained within 1year
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.