RN Care Manager II – Utilization & Transitions

Sutter Health; Sacramento (CA); On-site; USD 114,000 - 159,000; Full time

Benefits offered by this job

Equal opportunity employer

Full benefits

Job summary

Sutter Health in California is seeking a Registered Nurse to facilitate utilization management, ensuring the right care at the right time. The role conducts concurrent reviews, collaborates with care teams, and provides clinical information for payer reimbursement within an acute hospital setting.

Ideal candidates are graduates of accredited nursing programs with California RN licensure, plus 2 years of relevant experience.

Qualifications

• Graduate of an accredited school of nursing.
• Valid California RN license upon hire.
• 2 years of relevant recent experience preferred.

Responsibilities

• Facilitates utilization management (UM) to ensure appropriate admission, level of care, and transitions.
• Conducts concurrent review and resolves delays in care, service, or transition of care.
• Collaborates with treatment teams, patients, families, and payers to provide clinical information for reimbursement.

Skills

Nursing

Utilization management

Care transition

InterQual/MCG knowledge

Regulatory awareness

Education

Nursing degree

Tools

Microsoft Office

EMR systems

Job description

Sutter Health in California is seeking a Registered Nurse to facilitate utilization management, ensuring the right care at the right time. The role conducts concurrent reviews, collaborates with care teams, and provides clinical information for payer reimbursement within an acute hospital setting.

Ideal candidates are graduates of accredited nursing programs with California RN licensure, plus 2 years of relevant experience.