Case Manager (RN) - Utilization Management

Shasta Regional Medical Center; Redding (CA); On-site; USD 61,000 - 87,000; Part time

Job summary

Shasta Regional Medical Center in Redding, CA is seeking an experienced RN with case management and discharge planning expertise to oversee admission reviews and care coordination across the hospital stay.

This Per Diem, dayshift role requires strong clinical leadership and knowledge of utilization review criteria, collaborating with care teams. The organization emphasizes quality, compassion and community in patient-centered care.

Qualifications

• Minimum 5 years' work experience post-graduation from an accredited school of nursing
• Current state Registered Nurse license
• Experience in case management, discharge planning or nursing management
• Basic to intermediate computer skills

Responsibilities

• Responsible for the quality and resource management of all patients admitted to the facility across the continuum of care
• Promotes cost containment and leads integration of health care providers for seamless delivery of care
• Performs holistic admission and concurrent review of medical records for medical necessity and severity of illness

Skills

Case management experience

Discharge planning

Nursing management

Computer skills

Education

Nursing degree from accredited school

RN license (state)

Tools

Milliman Criteria

InterQual Criteria

Job description

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

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

Preferred Qualifications

• Five years of acute care nursing experience. preferred
• CCM or obtained within 1year
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• 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

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf