Case Manager (RN) - Utilization Management
About the Facility
Shasta Regional Medical Center is a 226-bed acute care facility serving Northern California, offering a comprehensive range of services. The hospital is recognized as one of the nation’s 50 Top Cardiovascular Hospitals by Watson Health, holds an ‘A’ Grade from the Leapfrog Group, and is Joint Commission Certified for Stroke, Hip/Knee, and Diabetes. It is a Five Star recipient for treatment of heart failure and respiratory failure, and is named among the top 5% in the nation for patient safety. Shasta Regional Medical Center delivers patient-centered healthcare with compassion, dignity, and respect for every patient and their family.
Responsibilities
- Manage the quality and resource utilization of all admitted patients across the continuum of healthcare.
- Advocate for cost containment while integrating healthcare providers to ensure seamless care delivery.
- Perform holistic and comprehensive admission and concurrent reviews of medical records for medical necessity, intensity of service, and severity of illness.
Requirements
- Minimum 5 years of work experience post-graduation 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.
Preferred Qualifications
- Five years of acute care nursing experience.
- Certification in Case Management (CCM) or obtained within 1 year of hire.
- Knowledge of Milliman Criteria and InterQual Criteria.
- Current BCLS certificate.
Pay
A reasonable compensation estimate for this role is $53.78 per hour. The exact starting compensation will be determined based on factors such as skillset, experience, education, credentials, and licensure.
Schedule
Per Diem, Day Shift.