Utilization Review Case Manager Extra on Call

About the role

This position coordinates utilization review service for defined patient populations across the acute care continuum, including discharge planning, utilization management, care coordination collaboration, and support for resource utilization. The role works collaboratively with an interdisciplinary team to improve patient care through the effective utilization of the facility's resources.

Responsibilities

• Coordinate utilization review services for patient populations
• Manage discharge planning and utilization management
• Collaborate on care coordination and resource utilization
• Work with an interdisciplinary team to enhance patient care

Requirements

• Current licensure as a Registered Nurse (RN) in the state of California
• Previous experience in at least two (2) areas of clinical specialty in an acute care setting
• Excellent communication, critical thinking, creative problem-solving, organizational, and planning skills
• Ability to work self-directedly while tolerating frequent interruptions and a demanding workload

Qualifications

• Current American Heart Association (AHA) Healthcare Provider CPR card (preferred)
• Degree from an accredited baccalaureate nursing program (BSN) (preferred)
• Certified Case Manager (CCM) national certification (preferred)
• InterQual training must be obtained within six (6) months of hire
• Knowledge of hospital protocols, clinical standards, funding options, community resources, and outside agencies (preferred)
• Familiarity with federal and state regulations governing hospital and home care (preferred)
• Understanding of the financial structure of health plans and delivery systems (preferred)

Pay

$49.47 - $71.74 per hour