Cedars-Sinai RN, Utlization Review Case Manager - Case Management in Los Angeles, California

You have the wisdom and stamina to steer crucial treatment

decisions.

As a Registered Nurse, Utilization Manager in Case Management at Cedars-Sinai

you will serve as a clinical co-pilot—charting the best trajectory of each

patient’s care by accommodating various needs, including medical,

psycho-social, financial and practical. So someone with your experience,

resourcefulness, perspective, confidence and capacity to communicate with top

physicians will have a major impact on the quality of your patients’ progress.

It is our shared culture of passion, compassion and sophistication that will

make your work experience here so exhilarating. An individual with your

curiosity and deep desire to broaden your scope of experience will grow and

thrive in our Magnet-designated, teaching environment, having all the advantages

of the most advanced thinking and state-of-the-art capabilities.

The RN, UM Case Manager, validates the patient's placement to be the most

appropriate level of care based on nationally accepted admission criteria. The

UR Case Manager uses medical necessity screening tools, such as InterQual or

MCG criteria, to complete initial and continued stay reviews in determining

appropriate level of patient care, appropriateness of test/procedures and an

estimation of the patients expected length of stay.

Note: All External Hires must successfully pass a background check, a

prohibited substance screening, and a pre-employment physical.

#LI-Nursing

Educational Requirements:

BSN preferred

License/Certification/Registration Requirements:

Current CA RN license, AHA BLS, Case Management Certification required within 2

years of hire.

Experience:

5 years acute Case Management experience and 3 years acute nursing experience

required. Very strong computer skills as employee will be entering information

into hospital system majority of the day, typing 35-40wpm, excellent verbal,

written communication skills required. Knowledge of medical literature,

research methodology, health care delivery systems and financial reimbursement.

In the role of Registered Nurse, UM you may have the opportunity to cross

train.

Physical Demands:

Able to walk, stand for long periods of time

EEO / AA / F / M / Veteran / Disabled.

Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.