Top 15 Utilization review nurse Jobs in Antioch, Ca

Care Manager II, Acute
Sutter Health —Antioch, CA
- $90.58 - $126.81 an hour
- 8 hour shift
- Acute care
- Nursing
- RN License
Case Manager - Ambulatory - 26-43
PriMed Management Consulting Services, Inc. —San Ramon, CA
- $100,000 - $123,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
Quick Apply
Registered Nurse
Caring Hand Home Health Solutions, Inc. —Rio Vista, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
10d
Psychiatric Nurse Practitioner
The Hume Center —Antioch, CA
- $176,000 - $215,000 a year
- Part-time
- Microsoft Word
- Nursing
- Microsoft Excel
Quick Apply
Registered Nurse - To service Contra Costa County and Alameda county
One Health Home Health —Livermore, CA
- $60,000 - $180,000 a year
- Part-time
- Remote
- CPR Certification
- Up to 50% travel
- RN License
- COVID-19 protective measures
- Flexible schedule
Quick Apply
Registered Nurse
Best Home Health Providers, Inc. —Contra Costa County, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Registered Nurse - Full or Part time- Contra Costa or Alameda County
One Health Home Health —Livermore, CA
- $60,000 - $180,000 a year
- Weekends as needed
- Remote
- CPR Certification
- Up to 50% travel
- RN License
- COVID-19 protective measures
- Flexible schedule
Quick Apply
Registered Nurse One Health seeks a Part Time, Full Time or
One Health Home Health —Livermore, CA
- $60,000 - $180,000 a year
- Weekends as needed
- Hybrid work
- CPR Certification
- Up to 50% travel
- RN License
- COVID-19 protective measures
- Flexible schedule
Quick Apply

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Case Manager - Ambulatory - 26-43
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Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)
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Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence. Exp. in the delivery of a health services program or…
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utilization review nurse jobs near antioch, ca

Care Manager II, Acute

Sutter Health -
Antioch, CA

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Job Details

Part-time
$90.58 - $126.81 an hour

Qualifications

Collaborate with healthcare professionals
RN License
Cross-functional communication

Full Job Description

We are so glad you are interested in joining Sutter Health!

Organization:

Bay Administration

Position Overview:

Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. The Care Management process encompasses communication and facilitates care across the continuum through effective resource coordination. The goals of this role are to include the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self –determination while coordinating in a timely and integrated fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. If assigned to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions.

Job Description:

EDUCATION:

Graduate of an accredited school of nursing

CERTIFICATION & LICENSURE:

RN-Registered Nurse of California Upon Hire

TYPICAL EXPERIENCE:

2 years recent relevant experience.

SKILLS AND KNOWLEDGE:

A broad knowledge base of health care delivery and case management within a managed care environment.
Comprehensive knowledge of Utilization Review, levels of care, and observation status.
Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, value-based reimbursement models, and alternative payment systems preferred.
Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, CDPH and TJC.
A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements.
General understanding of coding and DRG assignment process preferred.
Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
Demonstrates commitment to service excellence in all patients, family and employee interactions and in performing all job responsibilities.
Functions in a manner to promote quality patient care and assure a positive patient experience.
Strong verbal and written communication skills and negotiation skills
Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
Intermediate computer and technology skills.
Ability to promote teamwork and to effectively function in teams.
Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience.

Job Shift:

Days

Schedule:

Per Diem/Casual

Shift Hours:

Days of the Week:

Variable

Weekend Requirements:

Once a Month

Benefits:

Unions:

Position Status:

Non-Exempt

Weekly Hours:

Employee Status:

Per Diem/Casual

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $90.58 to $126.81 / hour

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

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utilization review nurse jobs in antioch, ca

Care Manager II, Acute

Case Manager - Ambulatory - 26-43

Registered Nurse

Psychiatric Nurse Practitioner

Registered Nurse - To service Contra Costa County and Alameda county

Registered Nurse

Registered Nurse - Full or Part time- Contra Costa or Alameda County

Registered Nurse One Health seeks a Part Time, Full Time or

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