Care Transitions Utilization Review Nurse opportunity with a respected Northern California hospital—an exciting chance to elevate patient flow, quality, and outcomes while shaping the future of care transitions and utilization management 🚀. The Care Transitions Utilization Review Nurse role blends strategy and bedside impact within a mission-driven, growth-oriented healthcare setting.
Why This Organization : The Care Transitions Utilization Review Nurse will join an award-winning, Joint Commission–accredited acute care hospital celebrated for patient safety, culturally responsive care, and high patient experience scores. The Care Transitions Utilization Review Nurse will benefit from investments in advanced technologies including an enterprise EHR, analytics-driven throughput tools, telehealth, and care coordination platforms, as well as innovative programs that reduce readmissions and advance value-based care. The Care Transitions Utilization Review Nurse will thrive in an organization known for philanthropy-supported initiatives, robust community partnerships, multilingual services, and a track record of clinical excellence recognized by independent quality rating organizations.
Structure, Support, and Responsibilities : The Care Transitions Utilization Review Nurse will report to the Director of Case Management within a collaborative service line that includes Utilization Management, Social Work, and Care Coordination, with medical staff alignment to a Physician Advisor/UM Medical Director. The Care Transitions Utilization Review Nurse will perform concurrent review using InterQual or MCG criteria, coordinate authorizations, manage denials and peer-to-peers, and partner closely with hospitalists, surgeons, pharmacists, and allied health professionals to optimize length of stay, level of care, and discharge readiness. The Care Transitions Utilization Review Nurse will collaborate with friendly nurses and a diverse healthcare professional team to drive safe transitions to SNFs, home health, rehab, and community resources while supporting CMS compliance, documentation integrity, and throughput metrics that elevate the patient experience.
Life in Northern California : The Care Transitions Utilization Review Nurse will enjoy a Northern California lifestyle defined by ocean vistas, redwood hikes, scenic wine country drives, and weekend adventures to lakes and mountains. The Care Transitions Utilization Review Nurse will have access to year-round festivals, world-class concerts, galleries, tech-forward innovation hubs, and a dynamic culinary scene featuring farmers markets, food halls, and global cuisine. The Care Transitions Utilization Review Nurse will appreciate mild Mediterranean weather, abundant outdoor recreation, bike-friendly neighborhoods, and easy access to regional attractions from the coast to the Sierra Nevada—all supporting a balanced, active, and culture-rich life.
Compensation, Benefits, and Next Steps : The Care Transitions Utilization Review Nurse will be offered a competitive salary commensurate with experience, along with a full suite of health and retirement benefits including medical, dental, vision, generous PTO, paid holidays, retirement plan with employer contribution, tuition and certification support, life and disability coverage, wellness resources, commuter benefits, and potential relocation or sign-on incentives based on organizational policy. The Care Transitions Utilization Review Nurse can launch a high-impact career move today—connect with a Clinical Management Consultants recruiter to learn more and confidentially explore this Utilization Review Nurse opportunity in Northern California 🌟.
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Looking for a job thats meaningful and enjoyableone that fits your life instead of the other way around? If you love working with children, want to make a positive impact each day, and enjoy meeting great families across your community, youre in the right place....