Overview Join the RN Case Manager - Utilization Review team at St. Francis Medical Center, a leading comprehensive healthcare institution in Los Angeles. St. Francis delivers vital medical services to 700,000 adults and 300,000 children, offering high‑quality, compassionate care in specialties such as Cardiovascular, Surgical, Orthopedics, Obstetrics, Pediatrics, Behavioral Health, and Emergency and Trauma Care. The hospital is a Comprehensive Stroke Center, STEMI Receiving Center, ED Approved for Pediatrics, Geriatric ED, Level III Neonatal ICU, and Level II Trauma Center. Please visit www.stfrancismedicalcenter.com for more information.
Responsibilities Responsible for the quality and resource management of all patients admitted to the facility from the point of their admission and across the continuum of health care management. Work on behalf of the advocate, promoting cost containment and demonstrating leadership to integrate health care providers to achieve a seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for medical necessity, intensity of service and severity of illness.
Qualifications Minimum 5 years work experience post‑graduation of an accredited school of nursing and a current state Registered Nurse license.
Grandfathered prior to April 1, 2015. Minimum 5 years post‑graduate of an accredited school of social work for Licensed Clinical Social Worker. RN Case Manager preferred.
Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management preferred.
Current BCLS (AHA) certificate, preferred.
Knowledge of Milliman Criteria and InterQual Criteria preferred.
Experience and knowledge in basic to intermediate computer skills.
Pay Transparency St. Francis Medical Center offers competitive compensation and a comprehensive benefits package that includes paid time off, a 401(k) retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many voluntary benefit options. The current compensation range for this role is $45.83 to $61.61 per hour. The exact starting compensation will be determined at the time of hire, considering skillset, years of applicable experience, education, credentials, and licensure.
Employment Status Full Time
Shift Evenings
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