Murrieta, CA · On-site
$20.50 - $26.25/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Murrieta, CA · On-site
$20.50 - $26.25/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Murrieta, CA · On-site
$59.18 - $79.60/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Murrieta, CA · On-site
$59.18 - $79.60/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Loma Linda, CA · On-site
$59.18 - $79.60/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
$20.50 - $26.50/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
$20.50 - $26.50/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
$20.25 - $26/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
$20.25 - $26/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
San Bernardino, CA · On-site
$35 - $40/hr
Under the direction of the Inpatient/Post-Acute Manager and RN leadership, the Concurrent Care Management LVN performs concurrent review, monitors inpatient and post-acute utilization, supports ...
San Bernardino, CA · On-site
$35 - $40/hr
Under the direction of the Inpatient/Post-Acute Manager and RN leadership, the Concurrent Care Management LVN performs concurrent review, monitors inpatient and post-acute utilization, supports ...
San Bernardino, CA · On-site
$35 - $40/hr
Under the direction of the Inpatient/Post-Acute Manager and RN leadership, the Concurrent Care Management LVN performs concurrent review, monitors inpatient and post-acute utilization, supports ...
San Bernardino, CA · On-site
$35 - $40/hr
Under the direction of the Inpatient/Post-Acute Manager and RN leadership, the Concurrent Care Management LVN performs concurrent review, monitors inpatient and post-acute utilization, supports ...
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Participate in utilization review and resource management processes as needed Required Skills * Acute Care Case Management * Discharge Planning * Care Coordination * Utilization Management
Participate in utilization review and resource management processes as needed Required Skills * Acute Care Case Management * Discharge Planning * Care Coordination * Utilization Management
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Participate in utilization review and resource management processes as needed Required Skills * Acute Care Case Management * Discharge Planning * Care Coordination * Utilization Management
Participate in utilization review and resource management processes as needed Required Skills * Acute Care Case Management * Discharge Planning * Care Coordination * Utilization Management
Loma Linda, CA · On-site
$68.03 - $91.49/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Loma Linda, CA · On-site
$68.03 - $91.49/hr
Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria ...
Interdisciplinary Collaboration The ideal candidate is a detail-oriented RN Case Manager with acute care hospital experience who excels in utilization review, discharge planning, and care ...
Interdisciplinary Collaboration The ideal candidate is a detail-oriented RN Case Manager with acute care hospital experience who excels in utilization review, discharge planning, and care ...
Orange, CA · On-site
$117K - $182K/yr
This role is responsible for promoting effective communication, transitional care, and utilization management, all while respecting patient autonomy and addressing social determinants of health.
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Orange, CA · On-site
$117K - $182K/yr
This role is responsible for promoting effective communication, transitional care, and utilization management, all while respecting patient autonomy and addressing social determinants of health.
Perris, CA · On-site
$49.83 - $63.20/hr
Follows patients throughout the continuum of care and ensures optimum utilization of resources ... Enhances the quality of patient management and satisfaction, to promote continuity of care and cost ...
Perris, CA · On-site
$49.83 - $63.20/hr
Follows patients throughout the continuum of care and ensures optimum utilization of resources ... Enhances the quality of patient management and satisfaction, to promote continuity of care and cost ...
Loma Linda, CA · On-site
$59.18 - $79.60/hr
The Case Manager utilizes clinical expertise, discretion, and independent judgment to apply specialized case and utilization management methodologies and practices to ensure medical appropriateness ...
Loma Linda, CA · On-site
$59.18 - $79.60/hr
The Case Manager utilizes clinical expertise, discretion, and independent judgment to apply specialized case and utilization management methodologies and practices to ensure medical appropriateness ...
The Case Manager utilizes clinical expertise, discretion, and independent judgment to apply specialized case and utilization management methodologies and practices to ensure medical appropriateness ...
The Case Manager utilizes clinical expertise, discretion, and independent judgment to apply specialized case and utilization management methodologies and practices to ensure medical appropriateness ...
The Case Manager utilizes clinical expertise, discretion, and independent judgment to apply specialized case and utilization management methodologies and practices to ensure medical appropriateness ...
The Case Manager utilizes clinical expertise, discretion, and independent judgment to apply specialized case and utilization management methodologies and practices to ensure medical appropriateness ...
$186K - $363K/yr
Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality member care - ensuring members receive the most appropriate care at the ...
$186K - $363K/yr
Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality member care - ensuring members receive the most appropriate care at the ...
San Bernardino, CA · On-site
$46.20 - $60.05/hr
This position will utilize specialized care management and utilization management methodologies with application in every-day practices. Will serve has a role model to other Care Management Team ...
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San Bernardino, CA · On-site
$46.20 - $60.05/hr
This position will utilize specialized care management and utilization management methodologies with application in every-day practices. Will serve has a role model to other Care Management Team ...
$40.7K - $52.9K
9% of jobs
$61.9K is the 25th percentile. Wages below this are outliers.
$52.9K - $65.1K
22% of jobs
$65.1K - $77.2K
11% of jobs
The median wage is $84.7K / yr.
$77.2K - $89.4K
14% of jobs
$89.4K - $101.6K
12% of jobs
$109.2K is the 75th percentile. Wages above this are outliers.
$101.6K - $113.8K
13% of jobs
$113.8K - $126K
13% of jobs
$126K - $138.2K
5% of jobs
$138.2K - $150.4K
2% of jobs
$150.4K - $162.6K
0% of jobs
$162.6K - $174.7K
0% of jobs
$40.7K
$94.9K
$174.7K
A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.
| Aspect | Utilization Manager | Utilization Coordinator |
|---|---|---|
| Certifications | Often requires healthcare or case management certifications | May have similar certifications but less emphasis on management |
| Work Environment | Typically in healthcare organizations, overseeing utilization review processes | Supports daily operations, assisting with case documentation and scheduling |
| Employer & Industry Usage | Common in healthcare, insurance, and managed care companies | Found in similar settings, often working under Utilization Managers |
In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.
$20.50 - $26.25/hr
Other
Posted 19 days ago
8.1
Based on 86 frontline employees who took The Breakroom Quiz
108th of 1,003 rated hospitals
MH: Case Management and Social- ( Part Time, Varied Shift) -
Job Summary: The Case Manager serves as a key member of the patient care delivery team and works efficiently in a fast-paced environment and utilizes clinical expertise, discretion and independent judgment in performing the nursing process (assessment, care planning, intervention, evaluation) within a patient-centered care professional practice model (Duffy's Quality-Caring Model) as it relates to case management functions. Maintains a solid working knowledge of specialized case and utilization management methodologies and practices and applies concepts to everyday practice. Ensures medical appropriateness criteria (medical necessity) are met for level of care provided and is documented from admission through discharge. Practices in a collaborative healthcare environment to oversee implementation of a well-thought-out interdisciplinary plan of care with an individualized discharge plan that is comprehensive and best meets the continuing healthcare needs of the patient. Reevaluates plan of care and ensures continued appropriateness based on the patients changing needs and condition. Represents nursing as an empowered profession and readily embraces new knowledge, innovations and improvements. Exhibits positivity and serves as an instrumental change agent and expertly minimizes resistance to change in the workforce, clinical practice and operational setting. Engages in opportunities to directly or indirectly influence decision-making for clinical practice by supporting and participating in committees, task forces and staff meetings. Performs other duties as needed.
Education and Experience: Bachelor of Science degree in nursing (BSN) required. Minimum two years of hospital nursing experience required. Minimum two years of case management, utilization review, or discharge planning experience in acute care environment preferred.
Knowledge and Skills: Basic knowledge of case and utilization management practice and methodologies and state and federal healthcare regulations and accreditation required. Able to: speak, read and write legibly in English (and Spanish preferred) with professional quality; use computer, printer and software programs necessary to the position, e.g., Microsoft Office Suite, Outlook, electronic medical record, electronic event reporting program. Relate and communicate positively, effectively and exhibit professional behavior at all times; work calmly and respond courteously when under pressure; be assertive and consistent in following policies; teach, and collaborate; accept direction; think critically; work independently with minimal supervision; perform basic math and statistical functions; manage multiple assignments effectively; organize and prioritize workload; problem solve; recall information with accuracy; pay close attention to detail; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position.
Licensures and Certifications: Active and unrestricted California Registered Nurse (RN) license required. Current Basic Life Support (BLS) certification issued by the American Heart Association required. Nationally recognized certification in Utilization Management or Case Management preferred.
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Loma Linda University Health (LLUH) is an esteemed healthcare organization situated in Loma Linda, California, US. Established in 1905, it was initially known as the College of Medical Evangelists, and it operated as the official medical institution of the Seventh-day Adventist Church until the name was changed to LLUH in 1961. LLUH is very much active in the healthcare and education sectors, providing a vast range of services such as medical treatment, research, and health education. The organization’s core mission is "to continue the teaching and healing ministry of Jesus Christ", which underlines its binding values of compassion, integrity, excellence, freedom, and justice.
Health care and social assistance and hospitality services
10,000+ Employees
Loma Linda, CA, US
