Case Manager: Care Coordination & Utilization Leader

Cullman Regional; Cullman (AL); On-site; USD 75,000 - 105,000; Full time

Job summary

Cullman Regional is seeking a Nurse in a Utilization Review/Case Management role to coordinate with physicians, nurses and social workers to expedite medically appropriate, cost-effective care and manage a designated patient caseload.

The position emphasizes leading quality improvement activities, ensuring adherence to clinical guidelines, and promoting patient safety and exceptional experiences across the care team.

Qualifications

• Nursing degree and Alabama license; BSN preferred.
• Minimum five years' clinical experience in acute care.
• At least one year in Utilization Review with JIVA/Interqual/Cerner/payors.
• Strong communication, interpersonal and organizational skills.

Responsibilities

• Coordinate with physicians, nurses, social workers and health team to expedite appropriate care.
• Support physicians with patient care, managing designated caseload.
• Facilitate precertification and payor authorizations and collaborate across care continuum.
• Lead quality improvement activities and ensure adherence to guidelines.
• Promote efficient resource use and maintain patient safety and outcomes.
• Demonstrate teamwork and deliver exceptional patient experiences.

Skills

Case management

Advanced communication

Organization

Microsoft Word

Excel

Education

Associate’s degree in nursing or higher

BSN preferred

Tools

JIVA

Interqual

Cerner

Microsoft Word

Excel

Job description

Cullman Regional is seeking a Nurse in a Utilization Review/Case Management role to coordinate with physicians, nurses and social workers to expedite medically appropriate, cost-effective care and manage a designated patient caseload.

The position emphasizes leading quality improvement activities, ensuring adherence to clinical guidelines, and promoting patient safety and exceptional experiences across the care team.