*Sign on Bonus: Up to $30,000 Sign on Bonus available for well qualified applicants*
Los Alamitos Medical Center is a 172-bed acute-care facility serving the residents of Orange County.
Los Alamitos Medical Center serves the Orange County and great Long Beach areas. Specializations include a dedicated outpatient facility that houses cancer, imaging, and infusion centers, a bi-plane catheterization lab, robot-assisted surgery capabilities, an Orthopedic Destination Center and radiation oncology physician services provided by UCLA Health. Awards and distinctions include the American Stroke Association Get With the Guidelines Gold+ Performance Achievement Award for Stroke with Honor Roll Elite Plus and Target: Type 2 Diabetes Honor Roll and a Comprehensive Stroke Center designation by DNV-GL.
We offer competitive salaries and benefits including a matching 401(k), several health & dental plans to choose from, generous tuition assistance plans, and relocation assistance for select positions.
Nursing Manager Utilization Review Summary:
This role provides leadership and support to the Director of Case Management (DCM) and is responsible for all Utilization Review functions/services within the hospital organization.
The role will assume responsibility for Utilization Management supporting medical necessity and denial prevention.
Role assumes 24/7 responsibility of Utilization Review staff.
The role is accountable to support DCM to ensure medical necessity review processes are completed accurately and in compliance with CMS regulations and Tenet policy. Also, this role is expected to implement and monitor processes to prevent payer disputes and support resolutions.
Responsibilities
- Active and current registered nurse license in the state of residence/practice.
- Highly effective interpersonal and communication skills.
- Proven leadership ability and hospital operational ability.
- Ability to serve as role model and advocate for the professional discipline of nursing.
Nursing Manager Utilization Review Full Time Days candidate will possess the following education, licenses/certifications, and experience:
Education
Required: Academic degree in nursing
Preferred: Bachelors or Masters degree
Experience
Required: 3 Years of Utilization Review or Case Management experience and progressive management experience in a hospital environment as a manager or full time supervisor/related position.
Certifications
Required: Must be currently licensed, certified or registered to practice profession as required by law, regulation in state of practice or policy. Preferred: CCM or ACM
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*AONE19*
Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.
Pay Range: $56.42 – $90.28
Individual wages are determined based upon a number of factors including, but not limited to, an employee’s qualifications and experience.
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Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.