Utilization Review Case Manager - Discharge Coordination

AHMC Healthcare Inc.; Monterey Park (CA); On-site; USD 90,000 - 110,000; Full time

Job summary

AHMC Healthcare Inc. in Monterey Park seeks a dedicated Case Manager for the Utilization Review Department. This full-time role follows an 8-hour day shift with a Saturday through Wednesday schedule, reporting to the Chief Operating Officer.

You will coordinate admission reviews, discharge planning, and post-discharge care with physicians, nursing, social services, and payors to ensure appropriate utilization and patient outcomes.

Qualifications

• Current California RN or CA LVN license required.
• 3–5 years case management (Utilization Review) preferred.
• 1 year hospital case management experience preferred.
• Bachelor's Degree preferred; BLS certification preferred.

Responsibilities

• Obtain Continuum of Care functions from admission to post-discharge placement.
• Initiate admission review, prioritize continue stay reviews, advise on care plans.
• Review TAR submissions and evaluate medical necessity with Interqual/MCG guidelines.
• Coordinate discharge planning and communicate with physicians, families, and payors.

Skills

Case management

Utilization Review

Communication

Discharge planning

Education

California RN license

CA LVN license

Bachelor's Degree

BLS certification

Job description

AHMC Healthcare Inc. in Monterey Park seeks a dedicated Case Manager for the Utilization Review Department. This full-time role follows an 8-hour day shift with a Saturday through Wednesday schedule, reporting to the Chief Operating Officer.

You will coordinate admission reviews, discharge planning, and post-discharge care with physicians, nursing, social services, and payors to ensure appropriate utilization and patient outcomes.