Job Description

A fantastic career opportunity for Nurse Manager of Care Management and Utilization Review is now available with a prestigious healthcare system in beautiful, warm and coastal Northern California!

The Nurse Manager of Care Management and Utilization Review will join a full-service, community hospital, offering comprehensive medical, surgical and therapeutic services. The hospital provides innovative, technologically advanced care on a patient-friendly, easy-access campus in the community.

The Nurse Manager of Care Management will need a thorough understanding of clinical, financial, administrative, and psychosocial components of the healthcare continuum. The Nurse Manager of Case Management will be responsible for providing assessments, planning, interventions and follow-up for patients and family members across the continuum of care.

In conjunction with the interdisciplinary team, the Nurse Manager of Case Management and Utilization Review will proactively address potential or actual clinical and/or psychosocial needs identified through screening to ensure developmental, level of care and health status transitions are safe, seamless, and coordinated. These services are provided face to face or telephonically to facilitate the creation of and adherence to, a treatment plan and optimize patient health.

The Nurse Manager of Case Management and Utilization Review should have experience with disease management, application of motivational interview techniques and competency in computerized documentation systems with 3-5 years in Care/ Case Management applying a working knowledge of community resources, entitlement programs, and experience working with uninsured/underinsured patient populations is preferred.

The ideal candidate for Nurse Manager of Care Management and Utilization Review will have experience with utilization review/ management with a working knowledge of InterQual criteria is strongly preferred. Minimum of 5 years of acute care clinical experience, preferably in one or more of the hospital’s service lines is required.

The Nurse Manager of Care Coordination and Utilization Review will have a family of healthcare professionals who not only enjoys outstanding benefits and professional growth opportunities, but also an environment noted for diversity, community involvement, intellectual excitement, artistic pursuits, and natural beauty. As an employee, you will enjoy generous benefits and work/life programs. Join the reputable team now!

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