Utilization Management Nurse

Pacer Staffing; Rancho Cordova (CA); Hybrid; USD 45,000 - 52,000; Full time

Job summary

A healthcare staffing agency is seeking a Delivery Manager for a 6-month contract role in Rancho Cordova, California. This position requires a California RN License and strong clinical background with at least 5 years of direct patient care experience. Responsibilities include reviewing patient admissions and planning discharges. Hybrid work model available.

Qualifications

• Must have a California RN License.
• Minimum of 5 years of prior relevant experience doing direct patient care.
• Strong communication and computer navigation skills.

Responsibilities

• Review inpatient stays and apply guidelines for care.
• Determine medical necessity for patient admissions.
• Involved with discharge planning and transfers.

Skills

California RN License

Clinical Background

Strong communication skills

Computer navigation skills (Office/Excel)

Job description

1 week ago Be among the first 25 applicants

This range is provided by Pacer Staffing. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$45.00/yr - $52.00/yr

Delivery Manager - Healthcare, Client Relationship Manager, VMS/MSPHiring Locums & Physicians/Nurses/Allied/Professional Coder Across with Best pay

Location if not remote: Rancho Cordova CA (HYBRID)

Travel Required? If so please elaborate.

YES May be asked to come to their assigned home office as needed.

Duration : 6 months contract to hire role

Shift : 8 AM - 5 PM PST

Required Skills

• Must have California RN License
• Must have Strong Clinical Background with a minimum of 5 years of prior relevant experience doing direct patient care.
• Must have Strong communication and computer navigation skills office/Excel
• UM experience with knowledge of MCG Criteria - Nice to have
• ER and/or ICU experience - Nice to have
• Medicare experience - Nice to have

Disqualifiers/ Dislikes on Resumes:

No Clinical experience. Many Short-term Jobs without explanation. Poor Computer Skills

Summary : The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role you will be assigned to members based on an alpha split and then review clinical information provided by facilities to determine medical necessity when our members admit. You will also be involved with discharge planning and transfers as needed for higher levels of care or out of network admissions.

Seniority level

Mid-Senior level

Employment type

Contract

Job function

Health Care Provider

Industries

Hospitals and Health Care