UM Case Manager - Emergency

Associate's Degree
Position Description
Evaluates the clinical status of patients using evidence based criteria to determine medical necessity for hospitalization, clinical progression and continued acute care needs. Utilizes information about clinical condition, prior level of functioning and anticipated treatment plan to suppport a safe, smooth transition to other levels of care. May perform other duties as assigned.
Job Specifications
Required Current unrestricted CA RN license. Graduate of accredited School of Nursing with Associates degree. BLS. Three years acute hospital experience; one year experience in Utilization Review or Case Management; discharge planning and/or case management. Knowledge of common disease processes and health care delivery systems; able to manage competing priorities and effectively prioritizes work; demonstrates effective communication, time management and problem solving skills, is adaptable, flexible and takes initiative. Basic computer and typing skills; willingness to learn all pertinent data entry and hospital-wide electronic medical record systems. Current knowledge/use of Milliman Care Guidelines.
Preferred Bachelor's degree preferred. AHA25



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