RN, Case Manager/ED Unit, Utilization Review, Per Diem (Weekends/Weekdays)

SMMC-SMMC Hospital
Per Diem
Day Job
Job Listing: 
Case Management - Utilization

Position Summary:

The RN Care Manager (ED) 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.



  • Current RN License in the State of California
  • BLS is required
  • Bachelor�s Degree in Nursing or higher
  • Certified Case Manager (CCM) highly desirable
  • Minimum 2-3 years Acute Hospital Nursing and 1-2 years Case Management and Utilization Review and Discharge Planning experience.
  • Milliman Care Guidelines utilization and Emergency Department UR experience is highly desirable.
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