Overview At St. Joseph Medical Center, our dedicated team of professionals is committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, St. Joseph Medical Center is actively seeking new members to join its award-winning team! Founded in 1874 by the Sisters of St. Joseph of Carondelet, St. Joseph Medical Center has a long tradition of providing high-quality, compassionate care. Its Catholic heritage and the spirit of our founding Sisters continue today in our mission of caring for the community. The Diocese of Kansas City-St. Joseph is the Catholic Sponsor for St. Joseph Medical Center, under the leadership of his Excellency Bishop James V. Johnston, Jr. St. Joseph Medical Center has received numerous awards for its quality and clinical excellence. We believe that continuous quality of care and performance improvements are the foundation for preserving and enhancing healthcare delivery. For information, visitwww.stjosephkc.com. Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management and Treatment Team meetings. . Responsible for reviewing patient charts in order to assess whether the criteria for admission and continuation of treatment is being met. Work with both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and use sound judgment. Knowledge of Federal, State, and intermediary guidelines related to inpatient, acute care hospitalization, as well as lower levels of care for the continuity of treatment. Coordinates discharge referrals as requested by clinical staff, fiscal intermediary, patients, and families. Work with all patients admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. Qualifications Education and Work Experience + Minimum 5 years work experience post-graduation of an accredited school of nursing and a current Missouri Registered Nurse license. + Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred. + Utilization Review experience is highly preferred. + Current BCLS (AHA) certificate, preferred. + Knowledge of Milliman Criteria and InterQual Criteria preferred. + Experience and knowledge in basic to intermediate computer skills. + Excellent written and verbal communication skills. Excellent critical thinking skills. + Behavioral Violence Prevention Training within 3 months of hires and maintain current. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/194396/rn-case-manager-utilization-review/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Joseph Medical Center LocationUS-MO-Kansas City ID2025-194396 CategoryRN Position TypePart Time < 60 ShiftDays Job TypeNon-Exempt