Job Details

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 safe, seamless, and coordinated developmental, level of care, and health status transitions. These services are provided face-to-face or telephonically to facilitate the creation 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 will have experience with utilization review/management with a working knowledge of InterQual criteria, which is strongly preferred. A 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 enjoy outstanding benefits and professional growth opportunities, in 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!