Nurse Manager, Case Management / Utilization Review

Management Escondido, California

Requisition ID
Clinical Resource Management
Escondido, California
Not Applicable
Job Type
Hours Per Shift
Hours Per Pay Period
Position at Palomar Health

The Manager, Clinical Resource Management (Case Management or Utilization Review) supervises, facilitates, and coordinates the Care Management system. This includes all the activities of the Case Managers and Social Workers. The position evaluates the patient care outcomes as well as the financial outcomes this system impacts. This position collaborates with all hospital departments within Palomar Health; medical staff, Home Health Care/Hospice agencies; durable medical equipment companies; nursing homes; and others to assure patient care coordination is efficient, of high quality and cost effective. He/she is responsible for the operational functions of the department including staffing, scheduling, performance management and financial/productivity. This position assists in teaching others how to analyze patient care data and how to present it to reach the goals of the organization. The position is required to work with all financial payers for reimbursement and excellent discharge planning. He/she follows Palomar Health's Values and assures that these standards are followed by the department's associates. Actively participates in development and monitoring of strategic initiatives as defined by the CRM leadership team.

Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.

Job Requirements

Minimum Education: Bachelor's Degree in Nursing/or related healthcare field.
Preferred Education: Master's Degree in Healthcare related field
Minimum Experience: 4+ years experience in Acute Hospital Case Management and/or Utilization Review
2+ years recent management/leadership experience
Preferred Experience:
Required Certification: American Heart Association recognized BLS - Healthcare Provider
Preferred Certification: Certified Case Manager
Required License: Valid Driver's License
Current CA RN License
Preferred License: Not Applicable


We are an equal opportunity employer and do not discriminate against applicants or employees based on race, color, gender, religion, creed, national origin, ancestry, age, disability, sexual orientation, marital status or any other characteristic protected by law.