Case Manager (RN) - Utilization Management

San Dimas Community Hospital; San Dimas (CA); On-site; USD 57,000 - 81,000; Full time

Benefits offered by this job

Per diem

Job summary

San Dimas Community Hospital in California seeks an experienced nurse to oversee admission and concurrent review, ensuring medical necessity and appropriate level of care across the patient journey.

You will lead care coordination with multidisciplinary teams to promote quality and cost-effective outcomes, with a per-diem schedule and daytime shifts. Requires five years post-graduate nursing, CA RN license, and experience in case management or discharge planning.

Qualifications

• RN license and active state licensure required.
• Minimum 5 years post-graduation nursing experience with case management, discharge planning or nursing management.
• Basic to intermediate computer skills.

Responsibilities

• Oversee admission and concurrent review to ensure medical necessity and appropriate level of care.
• Lead care coordination across providers to optimize quality and cost-effectiveness.

Skills

Case management experience

Discharge planning

Nursing management

Education

RN license

Tools

Computer skills

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! San Dimas Community Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! San Dimas Community Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

San Dimas Community Hospital is a 101 bed facility located on a 13-acre campus in the heart of San Dimas. With a multidisciplinary team of experts and state of the art technology, we are committed to serving the community with personalized, high-quality care. We offer a full range of comprehensive services, including 24-hour emergency services, a family birth center, orthopedic surgery, advanced diagnostic services, cardiopulmonary and gastrointestinal services. San Dimas Community Hospital has received multiple awards including the "100 Top Hospitals," Women's Choice Award for America's Best Hospitals for Patient Safety, and Healthgrades awards, including the "Patient Safety Excellence Award." Learn more at sandimashospital.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

San Dimas Community Hospital offers competitive compensation and a reasonable compensation estimate for this role is $50.00. 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