Hospital RN Nurse Case Manager Utilization Review UR

An established, trusted, and growing healthcare organization in the San Francisco Bay Area is actively interviewing Nurse Case Managers to fill crucial positions in its Hospital Utilization Review (UR) department. Join an amazing team of Bilingual RN Case Managers and help support a trusted and vital community organization.

This community hospital, in the heart of San Francisco, is actively interviewing RN Case Managers to support its Utilization Review process. This hospital, well-known for its dedication and long service to the communities of the Bay Area, has recently undergone an expansion to fulfill its missions. The UR Nurse will get to work with operations leaders from many different functions of this integrated health care system, supporting each.

Reporting to the RN Director of Care Management, Risk, and Patient Safety, the Hospital Utilization Review UR Nurse will work with a large, multidisciplinary team of Inpatient Certified Case Managers (CCM) and Ambulatory / Outpatient Case Managers to evaluate the hospitals resource use. The Case Manager / Utilization Review Nurse will also get to work alongside UR and CM specialists from the Health Plan to identify areas where shared resources and workflow processes can be improved or better utilized.

Though Concurrent Review will be the primary activity, the Utilization Review / Case Management RN will also get to lead Prospective and Retrospective Reviews in certain situations. You’ll perform on-site, virtual, and telephonic assessments across the entire continuum of care to plan and coordinate the highest quality of care with regards to both compensability and medical necessity.

One of the most important aspects of the Nurse of Utilization Review and Case Management’s role, will be working collaboratively with members of the health plan and hospital, supporting the patients’ families, and interfacing with external stakeholders to help create the best possible outcomes. As the Health Plan continues to add members, and the hospital begins serving a larger part of the community, compassionate care from Case Managers and UR Nurses will make all the difference in establishing the health systems reputation.

The San Francisco Bay Area is well known to have something for everyone. The artistic type, the gourmand, the outdoors person, and the home-body will all find something comforting. Contemporary street art, murals, galleries, and public installations adorn the streets just about everywhere you look. Hundreds of acres of coastline, nature trails, and parkland surround one of California’s most beautiful cities. With Silicon Valley and San Jose a short distance to the south, Stanford, UC Berkeley, and some of California’s best primary schools, the Bay Area is a great place for the UR Utilization Review Nurse to build a community and continue learning. Connected by Bay Area Rapid Transit and one of the nation’s best networks of buses and light-rails, you’ll find that it’s easy to get where ever you’re going.

The Case Manager / Utilization RN will play a direct role in realizing the organization’s growth and development plans. You’ll get the opportunity to work with a wide array internal and external partners, driving the health system’s mission with every decision. For the dedication and hard work that this role will require, the Director will receive a generous benefits package, a competitive compensation, and the job security that comes with a growing and healthy organization.