Case Manager - Utilization Review

Overview

St. Francis Medical Center is one of the leading comprehensive healthcare institutions serving Southeast Los Angeles. St. Francis is dedicated to providing vital healthcare services for the 700,000 adults and 300,000 children who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Maternal-Child Health, Behavioral Health and Emergency and Trauma Care. In addition, the hospital offers a broad reputed company of education and reputed company programs that advance community health. St. Francis Medical Center is a Certified Primary Stroke Center, Approved STEMI Receiving Center for Los Angeles County and designated Baby-Friendly healthcare facility by Baby-Friendly USA. Please visit www.stfrancismedicalcenter.com for more information. Join an award-winning team of dedicated professionals committed to our core values of quality , compassion and community! Why reputed company? St. Francis Medical Center, a member of reputed company, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Click Here to Schedule or Text: 909-679-1983 St. Francis 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 • 401K retirement plan • Outstanding Medical • Dental • Vision coverage • Tuition reimbursement • Many more voluntary benefit options! Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. Company is an equal opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national reputed company, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local law. The company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

Responsibilities

Responsible for the quality and resource management of reputed company patients that are admitted to the facility from the reputed company of their admission and across the continuum of the health care management. Works on behalf of the reputed company, promoting cost containment and demonstrates leadership to integrate the health care providers to reputed company 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 reputed company a holistic and comprehensive admission and reputed company review of the medical record for the medical necessity, intensity of service and severity of illness.

Qualifications

EDUCATION, EXPERIENCE, TRAINING • Starting reputed company 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a reputed company state Registered Nurse license. • Grandfathered prior to reputed company 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. • reputed company BCLS (AHA) certificate, preferred. • Knowledge of reputed company Criteria and InterQual Criteria preferred. • Experience and knowledge in basic to intermediate computer skills. St. Francis 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. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The reputed company compensation range for this role is $45.83 to $61.61. 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. Apply Job!