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

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Location: Laguna Hills, California

Schedule: Per Diem

Shift: Per Diem

Job Listing: SAD003192

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.


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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Photo of Brindilyn Berger
"I love working at Miller Children's & Women's Hospital Long Beach because I value working for a company that invests in its employees and the community we serve. From the support and guidance I receive from managers who value my professional and personal growth; to being able to work alongside colleagues who are dedicated to help their patients and families. I feel inspired every day to do the work that I love alongside people who share a similar vision."
- Brindilyn Berger, Child Life Specialist

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