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Case Manager RN - Utilization Review

Napa, CA · Healthcare
Schedule: Full-time - 80 biweekly hours

Shift: 8-hour Evenings

The RN Case Manager is responsible for carrying out effective case management functions for identified patients by planning, coordinating, negotiating, procuring and managing the care and needs of complex patients and their families throughout the continuum of care.The RN Case Manager assists patients in the utilization of appropriate health care services.Position may require Utilization Management and Discharge Planning, Chronic Disease Case Management based on inpatient settings.

Education: Bachelor degree in Nursing (BSN) or other healthcare related field

Two (2) years of combined clinical experience in an acute care hospital setting
One (1) year current experience in an inpatient or outpatient case management setting
Recent completion of a post-graduate level curriculum focusing on case management
Training: None

License / Certification:
  • Current California RN license
  • Current Healthcare Provider BLS certification
Preferred Qualifications:
  • Case management, discharge planning, or utilization management experience in the acute, sub-acute, home health setting or managed care environment
  • CCM or ACM Case Management certification
Knowledge, Skills, & Abilities:
  • Exceptional communication and interpersonal skills
  • Competent nursing assessment skills
  • Sensitivity to the needs and situations of a multicultural population from a variety of income levels
  • Strong organizational skills and ability to effectively present written and verbal information
  • Proficiency with computers and telecommunication devices, such as smart phones
  • Application of safety principles when performing duties
  • Demonstrates ability to maintain fiscal responsibility in service utilization
  • Ability to perform duties and responsibilities in an independent manner with little direct supervision, and complete job duties and responsibilities in a timely, accurate, thorough manner
  • Models professionalism through effective time management, efficiency and a positive team approach
  • Flexibility and an ability to adapt to changing and evolving hospital and departmental priorities
Kat Forester
ProEnlist, LLC

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