Case Manager (RN) - Utilization Management

The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Overview:

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Shasta Regional Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
 
Shasta Regional Medical Center is a 226-bed acute care facility serving Northern California. The hospital offers a comprehensive range of services. Shasta Regional Medical Center is one of the nation’s 50 Top Cardiovascular Hospitals recognized by Watson Health and holds an ‘A’ Grade from Leapfrog Group, the nation's premier advocate of transparency in health care. The hospital is Joint Commission Certified for Stroke, Hip/Knee and Diabetes. They are a Five Star recipient for treatment of heart failure, respiratory failure and is named among the top 5% in the nation for patient safety. Shasta Regional Medical Center delivers patient-centered healthcare with compassion, dignity and respect for every patient and their family. For more information, visit www.shastaregional.com.

 

Responsibilities:

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.  Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care.  The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. 

Qualifications:

EDUCATION, EXPERIENCE, TRAINING

Required Qualifications:

1.  Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
2. At least one year experience in case management, discharge planning or nursing management
3. Experience and knowledge in basic to intermediate computer skills.

 

Preferred Qualifications:

1. Five years of acute care nursing experience.  preferred
2. CCM or obtained within 1year
3. Knowledge of Milliman Criteria and InterQual Criteria preferred.
4. Current BCLS certificate, preferred

Pay Transparency:

Shasta Regional Medical Center offers competitive compensation and a reasonable compensation estimate for this role is $53.78. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status: Per Diem Shift: Days Equal Employment Opportunity: Privacy Notice:

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