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  • Case Manager - Utilization Management

    Prime Healthcare (Anaheim, CA)



    Apply Now

    Overview

     

    Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! West Anaheim Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Founded in 1964, West Anaheim Medical Center is a 219-bed acute-care hospital dedicated to providing the community with high-quality, compassionate healthcare. Key services include general medical and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more information visit www.westanaheimmedctr.com.

    Responsibilities

    Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived 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 the medical necessity, intensity of service and severity of illness.

    Qualifications

    EDUCATION, EXPERIENCE, TRAINING

    Required qualifications:

    1. BSW or other Bachelor degree in a related field or at least one year experience in case management, discharge planning or nursing management;

    2. Experience and knowledge in basic to intermediate computer skills.

    Preferred qualifications:

    1. Minimum 5 years of acute care experience preferred.2. Certified Case Manager (CCM) certification preferred.3. At least one-year experience in case management, discharge planning or management, preferred.4. Current BCLS certificate preferred.5. Knowledge of Milliman Criteria and InterQual Criteria preferred.

     

    Pay Transparency

     

    West Anaheim Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $30.28 to $43.32. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

     

    Employment Status

     

    Full Time

     

    Shift

     

    Days

     

    Equal Employment Opportunity

     

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf

     

    Privacy Notice

     

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

     

    Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case-manager---utilization-management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)

     

    FacilityWest Anaheim Medical Center

     

    LocationUS-CA-Anaheim

    ID2025-218947

    CategoryClinical Professional

     

    Position TypeFull Time

     

    ShiftDays

     

    Job TypeNon-Exempt

     


    Apply Now



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