Utilization Management RN, CHOC Health Alliance

Work Location

Orange, California

Work Shift

Day – 08hrs (United States of America)

Why CHOC?

At CHOC, we strive to be the leading destination of children’s health by providing exceptional and innovative care. We are responsible for the overall health of our community’s pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine. CHOC’s compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals. Apply now to see where your career at CHOC can take you.

Environmental Sustainability Statement

Driven by the connection between children's health and a healthy environment, we commit to creating a healthcare model that incorporates environmental sustainability aligned with our mission to protect children's health and patient safety.

Job Summary

The Utilization Management (UM) RN utilizes independent clinical judgement and expertise to coordinate benefit management, and promote quality, cost- effective health care. The UM RN works both independently, while also collaborating with the Medical Director and entire UM team, to ensure requests are reviewed with consideration to medical necessity, appropriateness of requested services and compliance with regulatory guidelines. This position requires attention to detail, outstanding organizational skills and efficient work habits.

Pay Range

Minimum $110,094 Midpoint $145,870 Maximum $181,626

Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.

Experience:

* Required: Minimum of two (2) years of pediatric experience

* Preferred: One or more years of Utilization or Case Management experience

Education:

* Required: Bachelor of Science in Nursing degree (BSN)

Specialized Skills:

* Required: Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision.

* Preferred: Experience with Cerner, MCG or other evidence-based clinical guidelines; EZ-Cap and/or Microsoft Office

Licensure:

Required: California Registered Nurse license.

Preferred: Basic Life Support (BLS) certification.

Work Environments - Functional Demand:

Light -

Moderate energy level Lift and carry 25-35 lbs. Push/pull 50-100 lbs. (ie. empty bed, stretcher).

Physical Activity Requirements:

Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation

Physical Activity Lifting

Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Occasional 0-35%

Sensory Requirements:

Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision

Environment Requirements:

Airborn Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations

Non-Discrimination Statement:

CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws.

We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn’t align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.

If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.