Utilization Review Coordinator

Community Health System

Fresno, California

JOB DETAILS
SKILLS
Basic Life Support (BLS), Case Management, Certified Case Manager (CCM), Clinical Nursing, Discharge Plans, Diversity, Healthcare Providers, Nursing, Organizational Skills, Quality of Care, Registered Nurse (RN), Utilization Management
LOCATION
Fresno, California
POSTED
1 day ago
Overview:

Opportunities for you! 

  • Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek 
  • Vacation time starts building on Day 1, and builds with your seniority 
  • Free money toward retirement with a 403(b) and matching contributions 
  • Great food options with on-demand ordering 
  • Free parking and electric charging 

 

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. 

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. 

 

Responsibilities:

The Utilization Review Coordinator is responsible for various aspects of utilization management to ensure that care is rendered in accordance with intensity of service and severity of illness standards at all times during the acute stay, utilizing InterQual system as a guideline. Works collaboratively with the Case Management team, other departments, and physicians to facilitate efficient and appropriate management of all cases.

Qualifications:
Education
• Associate's Degree in Nursing required
• Bachelor's Degree in Nursing preferred
 
Experience
• 2 years of clinical nursing experience required
• Experience in discharge planning, case management, or utilization review preferred
 
Licenses and Certifications
• RN - Current and valid Registered Nurse license to work within the state of California required
• BLS - Current Basic Life Support (BLS) for Healthcare Providers by American Heart Association (AHA) required
• ACM - Accreditation in Case Management preferred
• CCM - Certified Case Management preferred
Disclaimers:

• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.

About the Company

C

Community Health System

Community Health Systems, Inc. is a non-profit 501 (c) (3) 330 HRSA Grantee with Federally Qualified Health Center (FQHC) status. Established from the roots of Inland Empire Community Health Center in Bloomington, CHSI has grown with community health centers in the counties of Riverside, San Bernardino, and San Diego. These centers have been developed in accordance with standards established for safety net providers by the U.S. Department of Health and Human Services (HHS), the Health Resources Services Administration (HRSA), the Public Health Service (PHS), and the Bureau of Primary Health Care (BPHC).

As such, services are offered to the neediest in each community - the un-insured and under-insured, the working poor, those with limited ability to pay, the homeless, and the indigent. Services are provided at discounted (sliding fee scale) rates for those who qualify based on gross annual income and family size.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
FOUNDED
1985
WEBSITE
http://www.chs.net/