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Prime Healthcare

Acquires and reorganizes underperforming hospitals

Case Manager - RN, Utilization Management

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeChino, CA, USA$43.25 - $58.21In-person

About the Job

Requirements

  • Minimum five years of work experience after graduating from an accredited school of nursing and a current state Registered Nurse license.
  • At least one year of experience in case management, discharge planning, or nursing management.
  • Experience and knowledge in basic to intermediate computer skills.

Responsibilities

  • Manage the quality and resources of patients admitted to the facility, from admission and throughout the continuum of healthcare management.
  • Advocate on behalf of patients, promote cost containment, and integrate healthcare providers to support seamless care delivery.
  • Facilitate quality, clinical, and cost-effective outcomes.
  • Conduct holistic and comprehensive admission and concurrent medical-record reviews for medical necessity, intensity of service, and severity of illness.

Desired Qualifications

  • Five years of acute-care nursing experience.
  • Certified Case Manager (CCM) certification, or obtain it within one year.
  • Knowledge of Milliman Criteria and InterQual Criteria.
  • Current Basic Life Support (BCLS) certificate.

About the Company

Prime Healthcare

Acquires and reorganizes underperforming hospitals

Prime Healthcare operates a network of hospitals and outpatient centers across the United States, concentrating on turning around financially struggling facilities. It invests in infrastructure and technology, restructures operations, and negotiates payer terms (including pursuing higher out-of-network reimbursements) to improve financial performance, and it manages both for-profit hospitals and not-for-profit facilities through the Prime Healthcare Foundation. The company aims to raise clinical quality and patient safety while expanding access in hundreds of communities, though it has faced legal and regulatory scrutiny over billing practices and service-line decisions. Its goal is to stabilize and improve the financial and clinical performance of underperforming hospitals so they can continue serving their communities.

Company size
5,001-10,000
Company stage
Debt Financing
Total funding
$2.2B
Headquarters
Ontario, CA
Founded
2001

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