Top 7 Utilization management nurse Jobs in Samson Al

Care Manager - RN
Medical Center Enterprise —Enterprise, AL
- Up to $20,000 a year
- 8 hour shift
- Nursing
- RN License
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
9d
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance
Bilingual LPN Personal Care Coordinator I (Spanish)
Chartspan Medical Technologies Inc —United States
- $19.25 an hour
- Full-time
- Spanish
- Nursing
- LVN
Quick Apply

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utilization management nurse jobs near samson al

Care Manager - RN

Medical Center Enterprise -
Enterprise, AL

Quick Apply

Job Details

Full-time
Up to $20,000 a year
9 days ago

Benefits

Health insurance
Dental insurance
Vision insurance
401(k) matching

Qualifications

RN License
Associate's degree
Associate Degree in Nursing

Full Job Description

Join us as a Care Manager RN at Medical Center Enterprise!

Unit: Swing Bed/Rehab
Shift: Full Time, Mon-Fri, 8-hour shifts
Student Loan Contribution: Up to $20k
Other incentives include: Medical, Vision, Dental, 401k match & more available for Full and Part-Time roles

Job Summary

The Care Manager - RN is responsible for coordinating and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role involves collaborating with interdisciplinary teams, reviewing medical records for appropriateness and medical necessity, and maintaining compliance with federal, state, and accreditation standards.

Essential Functions

Conducts daily reviews of medical records to assess the appropriateness of admission, continued hospital stay, and utilization of diagnostic services.
Collaborates with interdisciplinary teams (IDT) to ensure effective communication and coordination of patient care, including identifying avoidable days and resolving care transition issues.
Develops and implements discharge plans, coordinating post-hospital placement and social services to meet patient needs.
Refers cases to physicians or managers when patients do not meet established criteria, ensuring timely and appropriate interventions.
Serves as a liaison with community agencies, maintaining relationships and facilitating seamless transitions for discharged patients.
Facilitates interdisciplinary meetings to address patient care needs, resolve challenges, and support collaborative care planning.
Maintains accurate and timely documentation of case management activities, including records of referrals, patient interactions, and compliance with reporting requirements.
Provides assistance to patients, families, and physicians regarding discharge planning and post-hospital care options.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.

Qualifications

Associate Degree in Nursing required
Bachelor's Degree in Nursing preferred
2-4 years of clinical nursing experience in a hospital, home health, or nursing home setting required
2-4 years of care management experience preferred

Knowledge, Skills and Abilities

Strong understanding of case management principles, discharge planning, and transitions of care.
Knowledge of federal, state, and Joint Commission standards related to case management.
Excellent communication and interpersonal skills to collaborate effectively with patients, families, and interdisciplinary teams.
Ability to assess complex situations, identify solutions, and implement care plans efficiently.
Proficiency in electronic medical records (EMR) and documentation systems.
Strong organizational and time management skills to prioritize tasks in a dynamic environment.

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure state licensure in state of employment or Compact state licensure required
Accredited Case Manager (ACM) preferred
CCM - Certified Case Manager preferred
BLS - Basic Life Support preferred

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utilization management nurse jobs in samson al

Care Manager - RN

Utilization Management Reviewer

Bilingual LPN Personal Care Coordinator I (Spanish)

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