Dignity Health
Utilization Review RN
– Dignity Health
We are looking for an RN Care Coordinator to oversee care progression and discharge planning for identified patients. This role supports quality of care and cost-effective outcomes while following hospital policies, standards, and federal and state regulations. Responsibilities include coordination with utilization management, nursing, physicians, ancillary departments, insurers, and post-acute service providers to progress care toward optimal outcomes. The Coordinator advocates for the patient and family, addressing patient choice, spiritual needs, cultural, language, and socioeconomic barriers to ensure smooth care transitions, enhancing the overall patient experience.
Job Requirements Minimum Qualifications
Graduate of an accredited school of nursing.
Minimum two (2) years of acute hospital clinical experience or a Master’s degree in Case Management or Nursing fields in lieu of 1 year experience.
RN license in the state(s) covered is required.
BLS required within 3 months of hiring.
Preferred Qualifications
Bachelor’s Degree in Nursing (BSN) or related healthcare field.
At least five (5) years of nursing experience.
Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification.
Ability to apply clinical guidelines to ensure progression of care.
Knowledge of managed care and payer environment.
Critical thinking and problem-solving skills.
Collaborates effectively with multiple stakeholders.
Professional communication skills.
Understanding of how utilization management and case management programs integrate.
Team player, assists other team members when needed.
Thrive in a fast-paced, self-directed environment.
Knowledge of CMS standards and requirements.
Proficient in prioritizing work and delegating when indicated.Highly organized with excellent time management skills.
Where You'll Work St. Elizabeth Community Hospital provides state-of-the-art health care to the North State communities. The award-winning facility is part of the Dignity Health system of providers, is a not-for-profit medical center, and offers 76 licensed beds, a trauma level III emergency department, comprehensive surgical services, and a progressive Family Birth Center. Located in picturesque Tehama County, St. Elizabeth has earned a Grade "A" from The Leapfrog Group for quality and safety for six consecutive award periods and is renowned for orthopedics, family-centered maternity care, and emergency services. It is a sister facility to Mercy Medical Center Redding and Mercy Medical Center Mt. Shasta, committed to providing the highest quality compassionate care available. For more information visit https://www.dignityhealth.org/north-state/locations/stelizabethhospital
Pay Range $52.59 – $68.92 per hour
Seniority Level Mid-Senior level
Employment Type Part-time
Job Function Health Care Provider
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– Dignity Health
We are looking for an RN Care Coordinator to oversee care progression and discharge planning for identified patients. This role supports quality of care and cost-effective outcomes while following hospital policies, standards, and federal and state regulations. Responsibilities include coordination with utilization management, nursing, physicians, ancillary departments, insurers, and post-acute service providers to progress care toward optimal outcomes. The Coordinator advocates for the patient and family, addressing patient choice, spiritual needs, cultural, language, and socioeconomic barriers to ensure smooth care transitions, enhancing the overall patient experience.
Job Requirements Minimum Qualifications
Graduate of an accredited school of nursing.
Minimum two (2) years of acute hospital clinical experience or a Master’s degree in Case Management or Nursing fields in lieu of 1 year experience.
RN license in the state(s) covered is required.
BLS required within 3 months of hiring.
Preferred Qualifications
Bachelor’s Degree in Nursing (BSN) or related healthcare field.
At least five (5) years of nursing experience.
Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification.
Ability to apply clinical guidelines to ensure progression of care.
Knowledge of managed care and payer environment.
Critical thinking and problem-solving skills.
Collaborates effectively with multiple stakeholders.
Professional communication skills.
Understanding of how utilization management and case management programs integrate.
Team player, assists other team members when needed.
Thrive in a fast-paced, self-directed environment.
Knowledge of CMS standards and requirements.
Proficient in prioritizing work and delegating when indicated.Highly organized with excellent time management skills.
Where You'll Work St. Elizabeth Community Hospital provides state-of-the-art health care to the North State communities. The award-winning facility is part of the Dignity Health system of providers, is a not-for-profit medical center, and offers 76 licensed beds, a trauma level III emergency department, comprehensive surgical services, and a progressive Family Birth Center. Located in picturesque Tehama County, St. Elizabeth has earned a Grade "A" from The Leapfrog Group for quality and safety for six consecutive award periods and is renowned for orthopedics, family-centered maternity care, and emergency services. It is a sister facility to Mercy Medical Center Redding and Mercy Medical Center Mt. Shasta, committed to providing the highest quality compassionate care available. For more information visit https://www.dignityhealth.org/north-state/locations/stelizabethhospital
Pay Range $52.59 – $68.92 per hour
Seniority Level Mid-Senior level
Employment Type Part-time
Job Function Health Care Provider
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