Case Manager, Utilization Review (Per-Diem)

Job Description

Job Description

Overview

Calling all Registered Nurses (RN) and Social Workers (BSW or MSW)! Apply today and join our outstanding Case Management team at VHC Health, where you’ll be part of a supportive, collaborative environment recognized for its commitment to excellence. In this role, you'll work with a dedicated, patient-first team that specializes in providing compassionate, safe, and efficient discharge plans for adult patients across various units, including medical, surgical, trauma, emergency, mom/baby, and behavioral health. Every day, you’ll bring your critical thinking and emotional intelligence to guide patients and families through some of life’s most challenging moments, connecting them with essential community resources while facilitating seamless transitions from hospital to home. You’ll work with a manageable 1:15 caseload, starting your day at 8:30 a.m. and ending at 5:00 p.m., with flexible start and end times to support individual needs.

Our department is led by an experienced leader with over 30 years in hospital case management, and new hires frequently comment on the supportive and collaborative atmosphere, calling it the best they’ve encountered. Leadership is proactive, regularly rounding to remove barriers and providing direct feedback in a non-punitive, growth-oriented environment. With a 2024 department-wide pay raise, weekend incentive pay, and numerous career growth opportunities, including programs for emerging and developing leaders, this is an environment where you can advance your skills and grow in your career. In fact, 40% of our team has been with VHC Health for over five years—a testament to the fulfilling, rewarding environment we’ve cultivated.

This role offers significant autonomy, allowing you to apply your critical thinking skills and work independently, all while knowing there’s a supportive team around you. Though you won’t perform direct patient care, you’ll have valuable bedside interactions with patients, families, and legal decision-makers. You’ll work closely with an interdisciplinary team, coordinating discharge plans and making appropriate referrals, documenting all activities in our Epic EMR system.

With new inpatient beds opening, increased internal growth opportunities, and an expanding team, this is a unique time to join us and make a difference. A year from now, we envision you as a high-performing team member who may be serving on hospital committees and representing VHC Health at community partnerships. If you’re a problem-solver who thrives in a fast-paced, team-centered environment, we invite you to explore this opportunity with us. Come make a lasting impact on patients’ lives and grow your career with VHC Health!

Responsibilities

At VHC Health, every role contributes to exceptional care, better outcomes, and stronger communities.  

In addition to your base compensation, VHC Health offers a comprehensive benefits package, including medical, dental, and vision coverage (subject to eligibility requirements), as well as additional wellness and retirement benefits designed to support our employees and their families. 

VHC Health is committed to wage transparency and equitable pay practices. The compensation offered for this position—whether expressed as an annual salary or hourly rate—is determined based on a variety of legitimate, non-discriminatory factors. These factors include, but are not limited to, a candidate’s qualifications, relevant training and experience, skill level, shift differentials (where applicable), internal equity, and current market conditions. 

The posted hiring range reflects the range VHC Health, in good faith, believes is appropriate for this role at the time of posting. This range may be adjusted in the future based on business needs or market changes. No portion of compensation is considered earned until it is vested and determined in accordance with the terms of applicable policies and benefit plans. The availability and amount of any bonuses, incentives, or other benefits are subject to the terms of those plans and may be modified at the sole discretion of VHC Health, in accordance with applicable law. 

VHC Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law. 

VHC Health maintains a drug-free workplace. The unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited at all VHC Health locations. 

Qualifications

Purpose & Scope:

The Case Manager is responsible for the collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective outcomes. Additionally, the Case Manager ensures that identified and referred patients have a coordinated continuum of care in accordance with JCAHO and hospital guidelines and serves as liaison for the interdisciplinary team, the patient, and family to ensure a timely, smooth, and clinically appropriate care planning process. The Case Manager also maintains communications with the pay or at the time of admission and throughout the hospitalization to ensure necessary approvals for care and clarification of benefits. They facilitate retrospective reviews and approvals for care whenever necessary, and they implement and coordinate discharge plans utilizing available and appropriate community resources.

Education:

Graduation from an accredited school of social work, nursing, in a related field or equivalent is required.

Experience:

Five years of experience in the healthcare field is preferred.

Experience in case management is preferred.

Certification/Licensure:

None.