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

SMMC-SMMC Hospital
Full Time
Day Job
Job Listing: 
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.  



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.


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.

Become part of Our Talent Network JOIN NOW

Sign up (Upcoming Career Events)