Hca Utilization Review Jobs (NOW HIRING)

Ready for a role that supports your unique calling in patient care and fits your life? At Alaska Regional Hospital, you’ll find clear pathways to advance backed by our unmatched nationwide transfer policy that lets you grow your career when the time is right for you. With mentorship opportunities, clinical education courses, professional certification support, and educational assistance, you will have all the resources you need to build the career of a lifetime.  

The Case Manager RN is responsible for the following functions: Utilization Review, Care Coordination, Resource Management, and Discharge Planning. The RN Case Manager will facilitate the interdisciplinary plan of care with a focus on evaluating the appropriateness of care, medical necessity, admission status, level of care, and resource management. The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. The RN Case Manager will identify potential barriers to patient throughput and quality outcomes and will facilitate appropriate discharge plans.

What you will do in this role:

• You will be responsible for promoting patient-centered care by coordinating the plan of care for the patient stay and managing the length of stay.
• You will ensure appropriate resource management and develop a safe and appropriate discharge plan in collaboration with the multidisciplinary team.
• You will facilitate the progression and transition of care using established criteria and in conjunction with the multidisciplinary team. 
• You will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization.
• You will direct activities to identify and provide for the needs of the under-resourced patient population to include patient education activities, patient assistance programs, and community-based resources.
• You will identify patients who are at risk for adverse outcomes during the transition from one level of care to another and, in partnership with Social Services, ensure the post-acute medical needs and levels of care are appropriate for those patients.

• Current licensure as a Registered Nurse in the State of Alaska or RN compact license from participating compact states.
• Associate Degree in Nursing required; BSN preferred.
• 2+ years of experience in case management or 3+ years of experience in clinical nursing required.
• American Red Cross or American Heart Association Basic Life Support Course (BLS or BCLS) and Certification.
• Certification in case management or utilization review preferred.
• InterQual experience preferred.

Alaska Regional Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

HCA Healthcare's Alaska Regional Hospital is known for our expertise, compassion and skills. We are committed to delivering patient-centered care to every patient on every visit for our 250 plus bed facility. Year after year, Alaska Regional receives 5-star ratings for heart attack treatment, bowel obstruction treatment, and colorectal surgery.

Based in Anchorage, Alaska Regional is located in a thriving community offering plenty of opportunities to capitalize on the Alaskan lifestyle. Alaska offers some of the most incredible scenic beauty around the world which draws visitors year-round who come for a vacation and end up making Alaska home.

We are part of the HCA Healthcare network - which includes more than 300 affiliate facilities across the country offering our colleagues the opportunity for travel and relocation. HCA Healthcare and Alaska Regional are inspired by our mission to care for and improve human life to create a positive impact in our community.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing’s future."

Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC

Senior Vice President and Chief Nurse Executive

HCA Healthcaret

Join a family that cares about every stage in your career! We are interviewing candidates for our RN Case Manager opening. Apply today and a member of our Talent Acquisition team will reach out.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.