Job Description

The RN Float Case Manager and Utilization Review Nurse provides coverage for an RN Case Manager or RN Utilization Review Nurse. The RN Float Case Manager and Utilization Review Nurse is assigned to function in the role of either a RN Case Manager or RN Utilization Review Nurse, as provided below.

When functioning in the role of a RN Case Manager: In collaboration with the interdisciplinary team, provides care coordination services evaluating options and services required to meet an individual's health care needs to promote cost-effective, quality outcomes.

Serves as a consultant to members of the health care team in the management of specific patient populations. The RN case manager role integrates the functions of utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services, including transfers to an alternative level of care.

When functioning in the role of a RN Utilization Review Nurse: The RN Utilization Management Specialist coordinates communication with admitting financial counselors, case management team, providers, patient financial services, and payers to ensure all services provided by the hospital are authorized by appropriate payer. 

Qualifications

Required Qualifications:

• Req 3 years Clinical experience.
• Req Knowledge of case management principles and healthcare management.
• Req Problem solving skills and ability to multi-task.

Preferred Qualifications:

• Pref Bachelor's degree Nursing
• Pref 1 year Case management or utilization review experience within the last three years preferred.

Required Licenses/Certifications:

• Req Registered Nurse - RN (CA DCA)
• Req Basic Life Support (BLS) Healthcare Provider from American Heart Association
• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

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