Utilization Management Nurse

**Job Description** Are you ready to bring your expert clinical skills to a world-class facility recognized as one of the top ten in the United States? Do you have a passion for the highest quality and patient happiness? Then please respond to this dynamic opportunity available with one of the best places to work in Southern California! We would be happy to hear from you. When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of happiness, passion and dedication pulses through Cedars-Sinai, and it's just one of the many reasons we've achieved our fifth consecutive Magnet designation for nursing excellence. From working with a team of dedicated healthcare professionals to using state-of-the-art facilities, you'll have everything you need to do something incredible-for yourself, and for others. Join us, and discover why U.S. News & World Report has named us one of America's Best Hospitals. As a Registered Nurse, Utilization Review Case Manager at Cedars-Sinai, + You will serve as a clinical co-pilot-charting the best trajectory of each patient's care by accommodating various needs, including medical, psycho-social, financial and practical. + You will join a shared culture of passion, compassion and sophistication that will make your work experience here exhilarating. + Your curiosity and dream to broaden your scope of experience will grow and thrive in our Magnet-designated, teaching environment, having all the advantages of the most advanced thinking and state-of-the-art capabilities. + You will validate the patient's placement to be the most appropriate level of care based on nationally accepted admission criteria. + You will use medical necessity screening tools, such as InterQual or MCG criteria, to complete initial and continued stay reviews, appropriateness of test/procedures and an estimation of the patients expected length of stay. **Qualifications** **Qualifications:** **Education:** + Graduate of an accredited nursing program required + BSN preferred **License/Certification:** + Current, unrestricted California RN license required + American Heart Association BLS required **Experience:** + A minimum of 5 years of Case Management experience required + At least 3 years of related nursing experience required + Knowledge of medical literature, research methodology, health care delivery systems and financial reimbursement required At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through March each year) as a condition of employment, and annually thereafter as a condition of continued employment. Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at View email address on click.appcast.io and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address. Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring. Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.