Top 5 Utilization review nurse Jobs in Klamath Falls, Or

Case Manager
Power Up Community Center —Klamath Falls, OR
- $22 an hour
- Contract
- Bilingual
- Background check
- HIPAA
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7d

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Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
Case Manager (RN) - Full-Time
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Current Licensure per state guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline.
$70,000 - $84,000 a year
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5d

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Case Manager

Power Up Community Center
Klamath Falls, OR

Quick Apply

Job Details

Contract
$22 an hour
7 days ago

Qualifications

Utilization review
Hospital medicine
Health insurance policy knowledge
HIPAA
Palliative care expertise
ICD-9
ICD-10
Electronic health record (EHR) management for billing and coding
Utilization management
Healthcare privacy protection
Resource utilization in healthcare
Health information regulatory compliance
Working with individuals from diverse cultural backgrounds
Emergency medicine
Health information management
Productivity software
Patient assessment visits
Managing patient records
Medical terminology

Full Job Description

Job Overview

We are seeking a dedicated and compassionate Case Manager to join our dynamic healthcare team. In this vital role, you will coordinate patient care plans, facilitate communication among multidisciplinary teams, and ensure seamless discharge planning to promote optimal health outcomes. Your expertise will help bridge gaps between hospital services, social support systems, and community resources, empowering patients on their journey to recovery and well-being. This position offers an exciting opportunity to make a meaningful difference in patients’ lives while working in a fast-paced, collaborative environment. Working with the homeless community and helping along side peers.

Duties

Conduct comprehensive patient assessments to determine individual needs across medical, social, and emotional domains.
Develop personalized care plans in collaboration with healthcare providers, social workers, and family members.
Coordinate with hospital departments such as ICU, emergency medicine, pediatrics, and hospice care to facilitate timely interventions and discharge processes.
Manage utilization review and utilization management activities to ensure appropriate resource use and compliance with insurance requirements.
Maintain accurate documentation within EMR (Electronic Medical Records) or EHR (Electronic Health Records) systems, including medical terminology, CPT coding, ICD-9/10 coding, and discharge summaries.
Communicate effectively with patients from diverse cultural backgrounds to provide education, support, and advocacy.
Facilitate intake processes for new patients and connect them with social services or community resources as needed.
Collaborate on discharge planning to ensure smooth transitions from hospital to home or other care settings while adhering to HIPAA regulations.

Requirements

Must have NPI, HIPAA, 1 Year of work experience.

Proven experience in critical care settings such as ICU or Level I/II trauma centers is highly preferred.
Strong hospital experience across various departments including emergency medicine, hospital medicine, pediatric units (PICU), or OR environments.
Background in nursing or social work with a solid understanding of medical terminology and healthcare workflows.
Knowledge of ICD-9/10 coding standards, CPT coding, and utilization review processes.
Familiarity with EMR/EHR systems and Microsoft Office applications for documentation and communication purposes.
Experience working within managed care environments and understanding health insurance policies.
Excellent client communication skills with the ability to work effectively with individuals from diverse backgrounds.
Ability to handle discharge planning efficiently while managing multiple priorities in a fast-paced setting.
Bilingual skills are a plus for serving diverse patient populations.

Join us as a Case Manager and be part of a passionate team committed to delivering exceptional patient-centered care! Your dedication will help improve health outcomes through coordinated services, resource management, and compassionate support — making a real difference every day!

Pay: $22.00 per hour

People with a criminal record are encouraged to apply

Work Location: In person

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