Utilization Review Case Manager Extra on Call Days

Posted Yesterday
Be an Early Applicant
Fresno, CA, USA
In-Office
49K-72K Hourly
Entry level
Healthtech
The Role
Coordinates utilization review, discharge planning, utilization management, care coordination, and resource utilization for acute-care patient populations. Collaborates with interdisciplinary teams to improve patient outcomes and ensure effective use of facility resources. Requires California RN licensure, acute-care clinical experience, strong communication and critical-thinking skills, and knowledge of hospital procedures, regulations, health-plan structures, and community resources.
Summary Generated by Built In
Employment Type:Part timeShift:12 Hour Day Shift

Description:

Reporting to the Manager Social Services, Social Services, this position coordinates utilization review service for defined patient populations across the acute care continuum. This includes discharge planning, utilization management, care coordination collaboration, and support for resource utilization. This position works collaboratively with an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. 

Requirements

1.  Current licensure as a Registered Nurse (RN) in the state of California is required.   
2.  Current American Heart Association (AHA) Healthcare Provider CPR card is preferred.   
3.  Degree from an accredited baccalaureate nursing program (BSN) is preferred.   
4.  Certified Case Manager (CCM) national certification is preferred.   
5.  InterQual training must be obtained within six (6) months of hire into position.   
6.  Previous experience in at least two (2) areas of clinical specialty in an acute care setting is required.   
7.  Excellent communication skills, critical thinking, creative problem-solving skills, and competent organizational and planning skills are required.   
8.  The incumbent must be self-directed and able to tolerate frequent interruptions with a demanding workload.   
9.  Knowledge regarding hospital protocol and procedures, clinical standards and outcomes, funding options, familiarity with community resources and outside professional agencies, familiarity with federal and state regulations governing hospital and home care, as well as understanding of the financial structure of health plan and delivery system is preferred. 

Pay Range

$49.47 - $71.74

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Skills Required

  • Current Registered Nurse licensure in California
  • American Heart Association Healthcare Provider CPR card
  • Bachelor of Science in Nursing degree from an accredited baccalaureate nursing program
  • Certified Case Manager national certification
  • Obtain InterQual training within six months of hire
  • Previous experience in at least two clinical specialty areas in an acute-care setting
  • Excellent communication skills
  • Critical-thinking and creative problem-solving skills
  • Competent organizational and planning skills
  • Self-direction and ability to tolerate frequent interruptions and demanding workloads
  • Knowledge of hospital protocols, clinical standards, outcomes, funding options, community resources, outside professional agencies, federal and state regulations, and health-plan financial structures
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The Company
HQ: Livonia, MI
6,824 Employees

What We Do

Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity Health system includes 88 hospitals, 131 continuing care locations, the second largest PACE program in the country, 125 urgent care locations and many other health and well-being services. Based in Livonia, Michigan, its annual operating revenue is $20.2 billion with $1.2 billion returned to its communities in the form of charity care and other community benefit programs.

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