Registered Nurse (RN), Case Manager,Utilization Review-FT/Days

Location: 
SMMC-SMMC Hospital
Schedule: 
Full Time
Shift: 
Day Job
Job Listing: 
SAD002998
Case Management - Utilization

Purpose Statement / Position Summary

The RN Care Manager is responsible for utilization review, multi-disciplinary care coordination and transition planning, for an assigned patient caseload. Role functions include: clinical assessment, payor communication for needed authorizations, and implementation of a patient / family centered plan of care across the continuum, to ensure optimal patient outcomes, including safe and timely transitions.  The success of the department is inherent in the individuals� ability to demonstrate positive, professional communication with patients/families, physicians, and other providers, and to meet / exceed benchmarks for quality outcomes, and financial targets.  

Qualifications: 

Experience

Prefer minimum 2-3 years Acute Hospital Nursing and 1-2 years Case Management and Utilization Review and Discharge Planning experience.Milliman Care Guidelines utilization highly desirable.

Education

Current RN License in the State of California and BLS is required.Prefer: Bachelor�s Degree in Nursing or higher.Certified Case Manager (CCM) highly desirable.

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