Case Manager - Utilization Management

primehealthcare· Clinical Professional
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📍 Anaheim, CA, USFULL TIME

About this role

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! West Anaheim Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Founded in 1964, West Anaheim Medical Center is a 219-bed acute-care hospital dedicated to providing the community with high-quality, compassionate healthcare. Key services include general medical and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more information visit www.westanaheimmedctr.com.

 

Responsibilities

Responsible for the quality and resource management of all patients that are 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.  The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. 

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

 

  • BSW or other bachelor's degree in a related field.  At least one year experience in case management, discharge planning or nursing management; or
  • Experience and knowledge in basic to intermediate computer skills.

    •  

    Preferred qualifications:

     

  • Minimum 5 years of acute care experience preferred.
  • CCM or obtained within 1year
  • Current BCLS certificate preferred.
  • Knowledge of Milliman Criteria and InterQual Criteria preferred.

    • Pay Transparency

    West Anaheim Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $30.28 to $43.32. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment Status

    Full Time

    Shift

    Days

    Equal Employment Opportunity

    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

     

    Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

     

    Frequently Asked Questions

    Is the salary disclosed for the Case Manager - Utilization Management position at primehealthcare?
    The salary for this Case Manager - Utilization Management role at primehealthcare is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
    Where is the Case Manager - Utilization Management position at primehealthcare located?
    This Case Manager - Utilization Management role at primehealthcare is based in Anaheim, CA, US. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
    Is the Case Manager - Utilization Management role at primehealthcare full-time or part-time?
    This is listed as a FULL TIME position. It is posted as a Case Manager - Utilization Management role in the Clinical Professional department at primehealthcare.
    Which team or department does the Case Manager - Utilization Management at primehealthcare belong to?
    This Case Manager - Utilization Management position is part of the Clinical Professional department at primehealthcare. See the full job description for more information about the team structure and responsibilities.
    How do I apply for the Case Manager - Utilization Management position at primehealthcare?
    Click the "Apply Now" button on this page. You will be redirected to primehealthcare's official application portal hosted on icims where you can submit your application directly.
    When was the Case Manager - Utilization Management job at primehealthcare posted?
    This Case Manager - Utilization Management position at primehealthcare was posted on Jun 9, 2026. Apply as soon as possible — early applications are often reviewed first.
    Case Manager - Utilization Management
    primehealthcare
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