About this opportunity
Valley-Presbyterian-Hospita lists this Registered Nurse Case Manager, Pre-Access - Per Diem Nights opportunity in california, Missouri. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Registered Nurse Case Manager, Pre-Access - Per Diem Nights
Job Category : Case Management
Requisition Number : REGIS
Posted : August 20, 2026
Part-Time
On-site
Locations
Showing 1 location
Pay or shift range: $57.29 USD to $70.97 USD The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.
Description
Valley Presbyterian Hospital
Ensure the Right Care, at the Right Time, in the Right Setting
At Valley Presbyterian Hospital, our Case Management team plays a critical role in supporting patient access, regulatory compliance, and efficient care delivery. We are seeking an experiencedRN Case Manager – Pre-Access to coordinate admission reviews, facilitate patient transfers, and ensure appropriate patient status determinations based on medical necessity guidelines. This role serves as a key liaison between physicians, nursing, admitting, financial services, and external healthcare organizations to support seamless patient access and optimal utilization of hospital resources.
What You'll Do
Review all acute care admissions to ensure appropriate patient status and level of care using established medical necessity criteria
Conduct admission reviews utilizing InterQual and other proprietary utilization review tools
Document admission determinations within the electronic medical record and utilization management systems
Collaborate with admitting physicians, Emergency Department providers, and hospital leadership to determine the most appropriate level of care
Coordinate patient transfers into the hospital, including obtaining clinical information and transfer agreements
Serve as a liaison between physician offices, admitting, nursing, business office, and ancillary departments to facilitate efficient admissions
Initiate physician advisor referrals when admission status or level-of-care determinations require additional review
Monitor observation patients and ensure appropriate status changes and documentation
Collaborate with Emergency Department leadership to improve patient throughput and bed utilization
Partner with Operations Supervisors regarding bed placement, patient flow, and special admission needs
Communicate payer requirements, utilization concerns, and reimbursement-related issues to physicians and care teams
Participate in departmental meetings, bed board huddles, and performance improvement initiatives
What You Bring
Strong clinical assessment and critical thinking skills
Expertise in utilization review, admission status determination, and medical necessity criteria
Knowledge of InterQual, CERME, Medicare, Medi-Cal, managed care, and third-party payer requirements
Understanding of EMTALA and other federal and state healthcare regulations
Ability to exercise independent judgment and make sound clinical decisions
Excellent communication and relationship-building skills
Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment
Ability to work collaboratively with physicians, nursing, case management, and operational teams
Experience
Minimum two (2) years of direct acute care nursing experience required
Critical Care experience preferred
Previous Case Management, Utilization Management, or Discharge Planning experience preferred
Education
Bachelor of Science in Nursing (BSN) required
Requirements
Current California Registered Nurse (RN) license
Management of Assaultive Behavior (CPI or equivalent) certification within 30 days of hire
LA City Fire Card certification within 30 days of hire
Why VPH
Mission-driven healthcare organization dedicated to exceptional patient care
Opportunity to impact patient access, quality, and resource utilization
Collaborative interdisciplinary environment
Dynamic role supporting hospital-wide patient flow and admission operations
Professional growth opportunities within Case Management and Care Coordination
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.
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Worksite address
california, MO, 65018, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.