RN Case Manager - Utilization Management

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Shasta Regional Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.Shasta Regional Medical Center is a 226-bed acute care facility serving Northern California. The hospital offers a comprehensive range of services. Shasta Regional Medical Center is one of the nation’s 50 Top Cardiovascular Hospitals recognized by Watson Health and holds an ‘A’ Grade from Leapfrog Group, the nation's premier advocate of transparency in health care. The hospital is Joint Commission Certified for Stroke, Hip/Knee and Diabetes. They are a Five Star recipient for treatment of heart failure, respiratory failure and is named among the top 5% in the nation for patient safety. Shasta Regional Medical Center delivers patient-centered healthcare with compassion, dignity and respect for every patient and their family. For more information, visit www.shastaregional.com.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.EDUCATION, EXPERIENCE, TRAINING

Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.

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.

Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred.

Current BCLS (AHA) certificate, preferred.

Knowledge of Milliman Criteria and InterQual Criteria preferred.

Experience and knowledge in basic to intermediate computer skills.

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/migratedfiles/employers/posterscreenreaderoptimized.pdf Shasta Regional 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 $32.50 to $55.00. 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.ID: 2023-122968 Street: 1100 Butte Street Shift: Days Exempt / Non-Exempt: Non-Exempt