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Registered Nurse (RN), Case Manager, Utilization Review, Full-Time, Days at Saddleback Memorial Medical Center

Posted in General Business 30+ days ago.

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Type: Full-Time
Location: Laguna Hills, California





Job Description:

Position Summery:

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, payer 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/Education:


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


  • Current RN License in the State of California required


  • BLS is required


  • Prefer: Bachelor's Degree in Nursing or higher, Certified Case Manager (CCM) highly desirable.