Utilization Review Case Manager Extra on Call Nights

Trinity Health Mid-Atlantic; Fresno (CA); On-site; USD 68,000 - 98,000; Part time

Job summary

Trinity Health Mid-Atlantic in Fresno, CA seeks a part-time RN in Social Services to coordinate utilization review across the acute care continuum, including discharge planning, utilization management and care coordination. This role reports to the Manager Social Services and requires collaboration with an interdisciplinary team to optimize resource use and patient care.

The ideal candidate holds CA RN licensure, may have BSN, and should bring strong communication and problem-solving skills to a

Qualifications

• Current licensure as a Registered Nurse (RN) in California is required.
• AHA Healthcare Provider CPR card is preferred.
• BSN from an accredited nursing program is preferred.
• Certified Case Manager (CCM) national certification is preferred.
• InterQual training must be obtained within six (6) months of hire into position.
• Previous experience in at least two (2) areas of clinical specialty in an acute care setting is required.
• Excellent communication skills, critical thinking, creative problem-solving skills, and competent organizational and planning skills are required.

Responsibilities

• Coordinate utilization review service for defined patient populations across the acute care continuum.
• Discharge planning and utilization management.
• Care coordina tion collaboration and support for resource utilization.
• Collaborate with an interdisciplinary team to improve patient care through effective use of resources.

Skills

RN licensure

AHA CPR

InterQual training

CCM certification

BSN preferred

Clinical specialty experience

Communication

Critical thinking

Organizational skills

Education

BSN preferred

Registered Nurse licensure (RN) in CA

Tools

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

• Current licensure as a Registered Nurse (RN) in the state of California is required.
• Current American Heart Association (AHA) Healthcare Provider CPR card is preferred.
• Degree from an accredited baccalaureate nursing program (BSN) is preferred.
• Certified Case Manager (CCM) national certification is preferred.
• InterQual training must be obtained within six (6) months of hire into position.
• Previous experience in at least two (2) areas of clinical specialty in an acute care setting is required.
• Excellent communication skills, critical thinking, creative problem-solving skills, and competent organizational and planning skills are required.
• The incumbent must be self-directed and able to tolerate frequent interruptions with a demanding workload.
• 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.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.