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Um/qi/capitation Nurse (rn) - Utilization Management

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Rady Children's Hospital-San Diego

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Location:
United States , San Diego

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Category:
Nursing

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Contract Type:
Not provided

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Salary:

45.75 - 62.90 USD / Hour
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Job Description:

Under the supervision of the Supervisor, UM Clinical, the Utilization/Case Manager Nurse coordinates the delivery of care through assessment, planning, facilitation, & patient advocacy to ensure cost-effective, quality outcomes of care. The Utilization/Case Manager Nurse works with all members of the health care team to ensure optimal outcomes are reached while appropriate utilization occurs

Job Responsibility:

  • Coordinates the delivery of care through assessment, planning, facilitation, & patient advocacy to ensure cost-effective, quality outcomes of care
  • Works with all members of the health care team to ensure optimal outcomes are reached while appropriate utilization occurs

Requirements:

  • Associate’s Degree
  • 3 years of experience
  • California RN License
  • Knowledge of common medical insurance operations
  • Managed Care experience (will consider Hospital Case Management Experience)
  • Strong mathematical and reasoning skills

Nice to have:

  • Bachelor’s Degree
  • Pediatric Nursing Experience
What we offer:
  • Medical, Dental, Vision, Life, Pet insurance
  • Retirement Plan
  • Tuition Assistance
  • Wellness program

Additional Information:

Job Posted:
April 23, 2026

Employment Type:
Fulltime
Work Type:
Hybrid work
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