Utilization Review / Discharge Planning

Plumas District Hospital • Quincy, CA

2d • $59 - $84

About The Position

This multifaceted role will focus on discharge planning, utilization review, and swing bed coordination within our healthcare facility. The Case Manager will play a pivotal role in ensuring the smooth transition of patients from the acute care setting to appropriate post-acute care options, while also managing utilization and assisting swing bed services.

Requirements

• A Minimum of three (3) years' experience in case management and utilization management.
• Bachelor's degree in a healthcare-related field (such as Nursing, or Healthcare Administration).
• Current healthcare licensure or relevant certification (e.g., RN or related lic.).
• Knowledge of insurance and Medicare/Medicaid regulations.
• Excellent communication and interpersonal skills.
• Strong organizational and time-management abilities.
• Ability to work collaboratively in a multidisciplinary healthcare team.
• Understanding of medical terminology and patient care.
• Excellent skills in crucial conversations, and emotional intelligence.

Responsibilities

• Conduct comprehensive assessments of patients' medical, social, and financial needs to develop effective discharge plans.
• Collaborate with physicians, nurses, social workers, and other healthcare professionals to ensure that patients receive the most suitable and seamless post-acute care.
• Coordinate and facilitate family meetings to educate and involve patients and their families in the discharge planning process.
• Monitor and update discharge plans to address evolving patient needs and conditions.
• Review and assess the medical necessity and appropriateness of care provided to patients.

Benefits

• Pay & Recognition
• Balanced Life
• Well-Being
• Professional Growth
• Dependent Care
• Child Care
• medical, vision, dental, 401k, retirement, paid time off, discounted memberships with Flight/American Medical Care Network, housing stipend or paid housing for first 3 months of employment, shift differentials

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees