Utilization Review Case Manager Extra on Call Days

Trinity Health; Fresno (CA); On-site; USD 68,000 - 99,000; Part time

Job summary

Trinity Health in California's Fresno area is seeking a part-time RN for utilization review and case management. The role centers on discharge planning, utilization management, and care coordination across the acute care continuum, reporting to the Manager Social Services.

You will collaborate with an interdisciplinary team to optimize resource use and ensure compliance with hospital protocols and regulations, while supporting patients and families through transitions toward high-quality,

Qualifications

• Current RN licensure in California is required.
• AHA CPR card preferred.
• BSN preferred.
• CCM preferred.
• InterQual training within six months of hire.
• Experience in at least two acute care specialties required.
• Strong communication, critical thinking, problem-solving and organizational skills.
• Self-directed and able to handle interruptions with a demanding workload.

Responsibilities

• Coordinate utilization review across the acute care continuum, including discharge planning.
• Support utilization management, care coordination, and resource utilization.
• Collaborate with an interdisciplinary team to improve patient care and outcomes.
• Maintain knowledge of hospital protocols, clinical standards, and funding options.

Skills

Registered Nurse (RN)

Utilization Review

Discharge Planning

Care Coordination

Interdisciplinary Collaboration

Communication

Critical Thinking

Organizational Skills

Education

BSN

CCM

InterQual Training

Two Clinical Specialties in Acute Care

Job description

Employment Type: Part time Shift: 12 Hour Day Shift

Description: Reporting to the Manager Social Services, Social Services, this position coordinates utilization review service for defined patient populations across the acute care continuum. This includes discharge planning, utilization management, care coordination collaboration, and support for resource utilization. This position works collaboratively with an interdisciplinary team to improve patient care through the effective utilization of the facility's resources.

Requirements

• 1. Current licensure as a Registered Nurse (RN) in the state of California is required.
• 2. Current American Heart Association (AHA) Healthcare Provider CPR card is preferred.
• 3. Degree from an accredited baccalaureate nursing program (BSN) is preferred.
• 4. Certified Case Manager (CCM) national certification is preferred.
• 5. InterQual training must be obtained within six (6) months of hire into position.
• 6. Previous experience in at least two (2) areas of clinical specialty in an acute care setting is required.
• 7. Excellent communication skills, critical thinking, creative problem-solving skills, and competent organizational and planning skills are required.
• 8. The incumbent must be self-directed and able to tolerate frequent interruptions with a demanding workload.
• 9. Knowledge regarding hospital protocol and procedures, clinical standards and outcomes, funding options, familiarity with community resources and outside professional agencies, familiarity with federal and state regulations governing hospital and home care, as well as understanding of the financial structure of health plan and delivery system is preferred.

Pay Range

$49.47 - $71.74

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.