Utilization Review Care Manager (RN)- Care Management

Cookeville Regional Medical Center; Cookeville (TN); On-site; USD 65,000 - 95,000; Full time

Job summary

Cookeville Regional Medical Center in Cookeville, TN is seeking a full-time Utilization Review Care Manager to lead quality and process improvements within Case Management. The role focuses on utilization review, discharge planning, and clinical pathway development to support optimal patient care and efficient transitions.

Candidates should have an RN license with 3–5 years of healthcare management experience, and a strong background in case management and utilization review.

Qualifications

• Associates or Bachelor’s Degree in Nursing required.
• State RN License required.
• Three to five years of health care management.
• Background in Case Management/Utilization Review.
• Knowledge of nursing procedures in designated patient populations.
• Knowledge of accounting, management and statistical principles.
• Knowledge and understanding of computer programs.
• Demonstrates physical capabilities with pressure to meet deadlines and expectations.

Responsibilities

• Direct and monitor activities related to quality and process improvement.
• Oversee case management and discharge planning for Pathways System.
• Develop clinical pathways and manage related duties as assigned.

Skills

Care management

Utilization review

Quality improvement

Case management

Discharge planning

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

RN License

Tools

Healthcare software

Job description

Cookeville Regional Medical Center

Cookeville , TN

Full Time Varied

The Utilization Review Care Manageris responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development, discharge planning for the Pathways System for Case Management . Other duties as assigned.

Education: Associates or Bachelors Degree in Nursing required. State RN License required.

Experience:Three to five years of health care management. A previous background in Case Management/Utilization Review. Knowledge of accepted Nursing procedures in designated patient populations as acquired through 5 years of clinical experience.
Knowledge of accounting, management and statistical principals. Knowledge and understanding of computer programs. Demonstrates physical capabilities with pressure to meet deadlines and expectations.