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RN, Care Manager, Utilization Management
Adventist Health Roseville, CA
$105k-134k (estimate)
Full Time | Elementary & Secondary Education 0 Months Ago
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Adventist Health is Hiring a RN, Care Manager, Utilization Management Near Roseville, CA

Adventist Health is ranked #10 in Becker's list of the largest nonprofit hospital systems in the U.S. We are the largest company headquartered and sixth largest employer in Roseville, California. Our corporate headquarters have been located at a desirable location on Douglas Boulevard since 1984. To accommodate our growing services, we are creating a new campus that will not only bring our workforce of nearly 900 people together in one location, but also facilitate a deeper connection with our Roseville neighbors and community.

Job Summary:

Reviews the utilization of resources and works to reduce unnecessary lengths of stay and the over utilization of hospital services. Reviews the medical record for quality and utilization indicators, recording and communicating identified variances as appropriate through data collecting forms and quality indicator monitoring processes. Communicates with the health care team, payers and others to promote quality cost-effective outcomes by utilizing available resources and decrease fragmentation of care across all settings. Responsible for promotion/role modeling, mentors staff, collaborates with on-site care management team. This is a remote - work from home position.

Job Requirements:

Education and Work Experience:

  • Associate’s Degree in nursing or equivalent combination of education/related experience: Required
  • Bachelor's Degree in nursing: Preferred
  • Five years' acute hospital RN experience: Required
  • Two years' CM/UM experience – may be waived with equal experience as an RN in an ED setting whose role includes discharge planning: Required
  • One year leadership experience: Preferred

Licenses/Certifications:

  • Registered Nurse (RN) licensure in the state of practice: Required

Essential Functions:

  • Completes a review of an acute medical patient to determine if the patient is in the right setting, receiving the right services and for the right length of stay, using a RN algorithm tool. The tool requires training and a strong broad baseline in nursing knowledge to accurately be applied. Yearly education and testing is required to remain compliant.
  • Notifies in-hospital care managers or physician advisors of any variances in services, stay or level for changes to be made.
  • Maintains education and learning on current processes/practices.
  • Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Elementary & Secondary Education

SALARY

$105k-134k (estimate)

POST DATE

05/25/2023

EXPIRATION DATE

05/25/2024

WEBSITE

adventisthealth.org

HEADQUARTERS

ROSEVILLE, CA

SIZE

1,000 - 3,000

FOUNDED

2019

CEO

JAMES E PEDERSEN

REVENUE

$200M - $500M

INDUSTRY

Elementary & Secondary Education

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About Adventist Health

Feather River Outpatient Ctr is an executive office company based out of 6283 Clark Rd # 4, Paradise, California, United States.

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