St Marys Regional Medical Center

Case Manager (RN) - Utilization Management

Chino, CA 91710In-Person
Hospitals & Medical Centers
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Minimum 5 years' nursing experience post-graduation from an accredited school.
  • At least 1 year of experience in case management or nursing management.
  • Basic to intermediate computer skills are essential.
  • Five years of acute care nursing experience preferred.
  • Certification in case management (CCM) preferred within 1 year.

Responsibilities

  • Manage quality and resources for patient admissions throughout their care journey.
  • Promote cost containment as a patient advocate.
  • Lead integration among healthcare providers for seamless care delivery.
  • Conduct comprehensive reviews of medical records for admissions and concurrent stays.
  • Ensure quality, clinical effectiveness, and cost-efficient outcomes.

Benefits

  • Flexible benefits package tailored to individual needs.
  • Paid time off included in the benefits.
  • 401K retirement plan available.
  • Medical, dental, and vision coverage provided.
  • Tuition reimbursement offered for further education.
Full Job Description
Responsibilities

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required Qualifications:
  1. Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
  2. At least one year experience in case management, discharge planning or nursing management
  3. Experience and knowledge in basic to intermediate computer skills.

Preferred Qualifications:
  1. Five years of acute care nursing experience. preferred
  2. CCM or obtained within 1year
  3. Knowledge of Milliman Criteria and InterQual Criteria preferred.
  4. Current BCLS certificate, preferred


Pay Transparency

Chino Valley Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $43.25 to $58.21. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

About St Marys Regional Medical Center

St. Mary's Regional Medical Center is a 229-bed hospital located in Enid, Oklahoma. The hospital offers a wide range of services, including emergency care, cardiology, orthopedics, surgery, and women's health. St. Mary's Regional Medical Center is part of SSM Health, a Catholic, not-for-profit health system serving communities across the Midwest. The hospital is committed to providing high-quality, compassionate care to all patients, regardless of their ability to pay.
Learn more about St Marys Regional Medical Center
Size
1,000 employees
Industry

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