Prime Healthcare

Case Manager - Utilization Management - RN

Facility Alvarado Hospital Medical Center
Location
US-CA-San Diego
ID
2022-103440
Category
RN
Position Type
Part Time < 60
Shift
Days
Job Type
Non-Exempt

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion, and community! Alvarado Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

 

Alvarado Hospital is a 306-bed full-service acute care hospital centrally located in San Diego adjacent to San Diego State University. Ranked in the top 5% nationally for patient safety, the hospital has also been ranked among America's 100 Best Hospitals for Orthopedic Surgery™, Spine Surgery™ and Critical Care™. Alvarado Hospital offers more than 25 programs and services, including the Advanced Spine & Joint Institute, cardiac services, San Diego Rehabilitation Institute outpatient rehabilitation, sexual medicine, geriatric-psychiatric care, vascular services, and an Emergency Department that is accredited for geriatric care. To learn more, visit www.AlvaradoHospital.com.

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 insure 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 and Work Experience

  1. Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
  2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred
  3. Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred
  4. Current BCLS (AHA) certificate, preferred
  5. Knowledge of Milliman Criteria and InterQual Criteria preferred
  6. Experience and knowledge in basic to intermediate computer skills
  7. Behavioral Violence Prevention Training within 3 months of hires and maintain current.

 

We are an Equal Opportunity/Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law:  https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf

 

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