Utilization Review Case Manager Extra on Call Nights

Saint Agnes Medical Center; Fresno (CA); On-site; USD 59,000 - 99,000; Part time

Job summary

Saint Agnes Medical Center in Fresno, CA, is seeking a Part-time RN to coordinate utilization review across the acute care continuum. The role involves discharge planning, utilization management, and care coordination with an interdisciplinary team to optimize hospital resources and patient care.

The ideal candidate holds an active CA RN license (BSN preferred) and may have CCM certification. InterQual training should be completed within six months of hire, with strong communication and

Qualifications

• Current RN license in California required.
• AHA CPR card preferred.
• BSN preferred.
• CCM certification preferred.
• InterQual training within six (6) months of hire.
• Experience in at least two acute care specialties required.
• Excellent communication, critical thinking, problem-solving, and organizational skills required.
• Self-directed and able to tolerate interruptions with a demanding workload.
• Knowledge of hospital protocols, funding options, and regulatory requirements preferred.

Responsibilities

• Coordinate utilization review for defined patient populations.
• Assist with discharge planning and resource utilization.
• Support utilization management and care coordination.
• Collaborate with interdisciplinary team to improve patient care.

Skills

Communication skills

Critical thinking

Problem solving

Organizational skills

Planning skills

Self-directed

Education

RN license CA

BSN preferred

CCM certification preferred

InterQual training

Job description

Employment Type: Part time

Shift: 12 Hour Night 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.