New

Case Manager RN - Utilization Review

22nd Century Technologies, Inc.
Pay rate: $88.00 - $106.00/Hou
United States, California, Vacaville
Jul 30, 2025
Job Title: Case Manager RN - Utilization Review Location: Remote Duration: 3 months to long term Shift: 1x8-Hour (08:00 AM - 04:30 PM) Saturdays only Pay rate: $88.00 - $106.00/Hour Role & Responsibilities: Applies MCG criteria to monitor appropriateness of admissions, level of care, and continued stays, and documents findings based on departmental standards and documents findings based on departmental standards. Documents interventions and reviews in Cerner. Manages the care of patients through the ED and health care systems based on the individual's needs. Works in collaboration with physicians, Social Services, and appropriate health care providers for changes in plans as required. Advocates for the patient and family throughout the entire episode of care. Maintains availability to the patient/family as a resource to facilitate communication among providers and to monitor services rendered. Develops an individualized comprehensive plan of care in collaboration with the physicians, Social Services, and interdisciplinary team. Proactive in communicating, assessing and reassessing patient throughout episode of care with development of alternative discharge plans as indicated. Works to transition patient to next appropriate level of care, appropriately involving Outpatient Case Management Services or other resources. Remains involved until the patient is discharged from the hospital and/or transfers case management function to inpatient case management staff or outpatient services utilizing SBARQ communication tool. Requirements: Registered Nurse License. BLS/CPR Certificate.