CASE MANAGER FT - Utilization Review
CULLMAN REGIONAL · cullmanregional.com
CullmanLead / Manager
Subscribers got this job on 11 October 2026.
New jobs reach them at 8 am and 6 pm, 5 days before they open here. Get the next one first
The job in short
Case manager for utilization review.
ExcelNursingICUClinical
Details
- Found
- 14 d ago · posted 2026-10-06
- Location as listed
- Cullman, AL, USA
- Role
- Social Worker / Case Manager
- Source
- The company’s own careers site
Full description
Job Details: Job Location: Cullman Regional Medical Center - Cullman, AL, Position Type: Full Time, Salary Range: Undisclosed, Job Shift: Any, Job Category: Nurse, Job Summary:
Coordinate with physicians, nurses, social workers and other health team members to expedite medically appropriate, cost-effective care.
Support physician provision of patient care with accountability for designated patient case load.
Facilitate precertification and payor authorization processes and facilitate collaborative management of patient care across the continuum, intervening as necessary.
Promote effective utilization and monitoring of healthcare resources and assumes a leadership role with the multidisciplinary team to achieve optimal clinical and resource outcomes.
Apply process improvement methodologies in evaluating outcomes of care.
Maintain and ensure adherence to clinical guidelines, tools and protocols based on evidence-based medicine related to quality measure indicators.
Assume leadership role in coordinating quality improvement activities related to quality measure initiatives.
Demonstrate and encourage team behavior and exceptional patient/guest experiences.
Uphold and promote patient safety and quality.
: Education:
Associate's degree in nursing or higher degree is required. Currently licensed by the state of Alabama. BSN preferred.
Experience:
Five years' clinical experience in acute care setting i.e., medical surgery, ICU, ER, OR required. Previous Utillization Review experience is preferred.
Additional Skills/Abilities:
Skill and proficiency in applying highly technical principles, concepts and techniques that are central to case management. Advanced communication and interpersonal skills with all levels of internal and external customers. Must be proficient in Microsoft Word and Excel. Familiar with CMS Guidelines, navigating within payor portals, following up on pending approvals/denials. Excellent organizational skills are required. Must be able to set priorities appropriately and handle multiple issues concurrently.
Social Worker / Case Manager jobs in the United States · All CULLMAN REGIONAL jobs