Top 24 Utilization review nurse Jobs in Fairfield Ca

RN - Case Manager - AS Utilization Management - Full Time - 8 Hour - Days
John Muir Health —Concord, CA
- $89.23 - $121.58 an hour
- 8 hour shift
- Nursing
- Microsoft Outlook
- RN License
Travel RN Case Manager/Care Coordinator $80/HR
MTK Healthcare —California
- $76 - $80 an hour
- 8 hour shift
- Background check
- RN License
- Hospital
Quick Apply
6d
Registered Nurse
Caring Hand Home Health Solutions, Inc. —Vallejo, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Registered Nurse
Best Home Health Providers, Inc. —Napa, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Care Manager II, Acute
Sutter Health —Antioch, CA
- $86.68 - $114.41 an hour
- 8 hour shift
- Acute care
- Nursing
- RN License
Advanced Practice Practitioner - Primary Care (32 hours per week, M-T, Th-F)
Sonoma Valley Hospital —Sonoma, CA
- $76.50 - $110.45 an hour
- Full-time
- Bilingual
- Nursing
- RN License
Psychiatric Nurse Practitioner
The Hume Center —Antioch, CA
- $176,000 - $215,000 a year
- Part-time
- Microsoft Word
- Nursing
- Microsoft Excel
Quick Apply
1d

Other jobs to consider

Find your next job by exploring related positions.

Nurse Director Utilization Review and Case Management
Clinical Management Consultants —Berkeley, CA
Settle into the Bay Area lifestyle and the Nurse Director Utilization Review and Case Management role simultaneously: enjoy year-round sunshine and coastal…
$152,580 - $175,960 a year
Supervisor of Utilization Management
Partnership HealthPlan of California —Fairfield, CA
This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage.
$141,067.17 - $183,387.32 a year

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

MDS Coordinator - LVN/RN
Paradigm at Creekside —Gahanna, OH
Must possess a current, unencumbered, active license to practice as a Licensed Practical Nurse or Registered Nurse in the State.
Quick Apply
Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per…
Quick Apply

Show more jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in fairfield ca

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review nurse jobs near fairfield ca

Registered Nurse Case Manager jobs in Concord, CA

Registered Nurse jobs in Vallejo, CA

Registered Nurse jobs in Napa, CA

Psychiatric Nurse Practitioner jobs in Antioch, CA

Registered Nurse Case Manager jobs in Paducah, KY

Registered Nurse Rn jobs in Sacramento, CA

Registered Nurse Case Manager jobs in Davenport, FL

Case Management Assistant jobs in Baltimore, MD

Registered Nurse Pension jobs in New York State

Registered Nurse Case Manager jobs in Kalispell, MT

Registered Nurse Case Manager jobs in Austin, TX

Case Worker jobs in San Antonio, TX

Registered Nurse jobs in Greenland, NH

Registered Dietitian jobs in West Virginia

Registered Nurse jobs in Redlands, CA

School Nurse jobs in Yonkers, NY

Mother Baby Nurse jobs in Wisconsin

Registered Nurse jobs in Fort Myers, FL

Registered Nurse jobs in Cumming, GA

Oncology Nurse jobs in Maine

RN - Case Manager - AS Utilization Management - Full Time - 8 Hour - Days

John Muir Health -
Concord, CA

Apply Now

Job Details

Full-time
$89.23 - $121.58 an hour

Qualifications

RN License
BLS Certification
Master's degree in nursing
Master's degree

Full Job Description

Job Description:

The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the patient’s health care needs through hospitalization and transition back to the community and does this in coordination with the interdisciplinary health team.
The RN Case Manager is expected to function within the full scope of the nursing practice with specialized focus on care coordination, compliance, transition management, education, and utilization management.

Education:

Master's Degree Accredited School of Nursing Required

Experience:

2 years Case Management or Equivalent Work Experience Preferred
3 years Nursing - Medical/Surgical Preferred
3 years Nursing - Critical Care Preferred

Certifications/Licensures:

RN Registered Nursing - California Board of Nursing Required
BLS Basic Life Support - American Heart Association Required
ACM Accredited Case Manager - ACMA American Case Management Association or
CCM Certified Case Manager - CCMC Commission for Case Manager Certification Strongly Preferred

Skills:

Strong written and verbal communication skills. Effectively motivates teams.
Strong knowledge of Medicare and Medi-Cal guidelines and benefit resources as applicable to hospitalization and transition planning.
Working knowledge of common diagnoses and procedures and the impact this will have to patients/families and their ability to manage their care outside of the hospital. Specialized knowledge may be required for certain areas of practice.
Knowledge of individual and family development over the life span, and the influences of cultural and spiritual values in health care.
General knowledge of commercial coverage plans and usually covered benefits. Strong understanding of various reimbursement models and impact to care delivery, patient management and reimbursements such as ACOs, DRGs, Full Risk, etc.
Strong understanding of the criteria, rules and regulations around Inpatient, Observation and Outpatient levels of patient management. Strong knowledge of geriatrics and the impact to health and function in the aged as well as a working knowledge of chronic/progressive disease states such as CHF, COPD, Diabetes and End Stage Renal Disease, etc. Clear understanding of the role of the inpatient Social Worker and Palliative Care Resources.
Ability to plan, organize, manage time and prioritize work in collaboration with others.
Ability to work independently and as a part of a multidisciplinary team.
Effective problem solving and conflict resolution skills.
Ability to work respectfully and creatively with clients of diverse functional abilities, social, economic, and cultural backgrounds to support both client autonomy and client safety.
Leadership skills to delegate and provide direction/guidance to staff and hold others accountable.
Able to learn and work in a variety of computer programs, including EPIC, MIDAS, Allscripts, and Microsoft Outlook.

Fixed Schedule:
Week 1: Sun-Wed
Week 2: Sun-Thurs

Work Shift:

08.0 - 08:00 - 16:30 No Waive (United States of America)

Pay Range:

$89.23 - $121.58 Hourly

Offer amounts are based on demonstrated/relevant experience and/or licensure.

Pay will be adjusted to the local market if hired outside of the Bay Area.

Note: Positions at JMH which are exempt (not eligible for overtime) under the level of Manager are listed as hourly for compensation purposes on this posting. The work shift will contain the word ‘exempt’ on it.

Scheduled Weekly Hours:

Apply Now

Refine Your Search

utilization review nurse jobs in fairfield ca

RN - Case Manager - AS Utilization Management - Full Time - 8 Hour - Days

Travel RN Case Manager/Care Coordinator $80/HR

Registered Nurse

Registered Nurse

Care Manager II, Acute

Advanced Practice Practitioner - Primary Care (32 hours per week, M-T, Th-F)

Psychiatric Nurse Practitioner

Other jobs to consider

Explore jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in fairfield ca

Explore jobs in more locations

Job Description:

Work Shift:

Scheduled Weekly Hours:

Job Seeker Tools

Employer Tools

Browse

Stay Connected