Senior Registered Nurse - Utilization Management

Job Description:

Senior Registered Nurse - Utilization Management

Description

Description

Under general direction and following established medically approved policies and procedures, the incumbent implements specialized skilled nursing processes in designated hospital units of Ventura County Medical Center and Santa Paula Hospital. The Senior Registered Nurse-Hospital works collaboratively with a medical doctor to coordinate and screen for the appropriateness of admissions and continued stays. They make recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for inpatient hospitalization. They interact with the family, patients, and other disciplines to coordinate a safe and acceptable discharge plan. They function as an indirect caregiver, patient advocate, and manage patients in the most cost-effective way without compromising quality. They will also be responsible for complying with AB 1203, Post Stabilization notification.

AGENCY/DEPARTMENT: Health Care Agency - Ventura County Medical Center and/or Santa Paula Hospital

PAYROLL TITLE: Senior Registered Nurse-Hospital

Senior Registered Nurse-Hospital is represented by the California Nurses' Association (CNA) and is eligible for overtime compensation. Salary placement will be determined according to the current CNA memorandum of agreement.

The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-term), Intermittent, and Extra Help vacancies. There is currently one (1) Regular vacancy.

TENTATIVE SCHEDULE
OPENING DATE: 5/19/26
CLOSING DATE: 6/2/26

Examples Of Duties

Duties include, but are not limited to the following:

• Plans, develops, assesses, evaluates, and coordinates care provided to patients/members to ensure quality, continuity, and appropriate resource utilization.
• Collaborates with physicians, multidisciplinary healthcare teams, patients, families, caregivers, and community agencies in the development, implementation, and documentation of individualized plans of care.
• Conducts utilization management and quality management reviews for patients in outpatient, emergency room, inpatient, and other healthcare settings using established guidelines and standards.
• Reviews, monitors, evaluates, and coordinates patient care and hospital stays to ensure appropriate, timely, and efficient delivery of services.
• Assesses high-risk patients and develops, coordinates, and implements discharge and post-hospital care plans to meet identified patient needs.
• Coordinates interdisciplinary care planning activities, patient family conferences, bed huddles, transfer coordination, discharge planning activities, and continuity of care services.
• Coordinates transfers and referrals to appropriate facilities, providers, and community resources, including obtaining required authorizations and maintaining required documentation.
• Acts as a liaison between healthcare facilities, referral agencies, providers, patients, and families regarding care coordination and case management activities.
• Recommends alternative levels of care and ensures compliance with applicable federal, state, local, regulatory, accreditation, and organizational requirements.
• Educates healthcare team members regarding discharge planning processes, resource utilization, care coordination practices, and related responsibilities.
• Provides patients and families with education and support regarding discharge planning, post-hospital care, and coping with acute or chronic illnesses.
• Identifies, reports, and documents unusual occurrences, quality concerns, patient safety issues, risk management concerns, and inappropriate utilization of resources in accordance with established protocols.
• Reviews, analyzes, and monitors utilization patterns, trends, and data to support studies, projects, planning activities, and routine utilization monitoring functions.
• Participates in committees, teams, care planning activities, special projects, and other related duties as assigned.
• Performs other related duties as required.

Typical Qualifications

These are entrance requirements to the examination process and assure neither continuance in the process nor placement on an eligible list.

EDUCATION, TRAINING, and EXPERIENCE
Requires two (2) years of full-time professional registered nurse experience, including two (2) years in an acute care setting.

NECESSARY SPECIAL REQUIREMENTS

• Must possess and maintain a current, valid license as a Registered Nurse issued by the State of California.
• Must have a current, valid Basic Life Support (BLS/CPR) certification by first day of employment.
• Must be able to work collaboratively with the multidisciplinary team, multitask and work in a fast-paced environment.

KNOWLEDGE, SKILLS, and ABILITIES:
Knowledge of:

• Principles, practices, and techniques of utilization management, utilization review, discharge planning, care coordination, and case management in an acute care setting.
• Applicable federal, state, local, regulatory, and accreditation requirements related to healthcare delivery, patient care, utilization management, and discharge planning, including Medicare, Medi-Cal, and Joint Commission standards.
• Nursing principles, clinical assessment methods, and standards of patient care applicable to acute care and hospital settings.
• Community resources, post-acute care services, referral processes, and continuity of care practices.
• Quality management, patient safety, risk management, and performance improvement principles and practices.
• Methods and techniques used in patient, family, and staff education.

Skill in:

• Assessing, evaluating, and coordinating patient care needs and appropriate levels of care.
• Interpreting and applying clinical guidelines, medical necessity criteria, policies, procedures, and regulatory requirements.
• Utilizing electronic medical records, healthcare information systems, and standard office software applications.

Ability to:

• Collaborate effectively with physicians, multidisciplinary healthcare teams, patients, families, caregivers, community agencies, and outside providers.
• Analyze clinical information, identify utilization trends or concerns, and make sound recommendations regarding patient care and resource utilization.
• Communicate effectively both orally and in writing, including explaining complex medical and discharge planning information to diverse audiences.
• Organize, prioritize, and coordinate multiple assignments in a fast-paced healthcare environment while maintaining accuracy and attention to detail.
• Exercise sound judgment, maintain confidentiality, and respond effectively in stressful, sensitive, or emergency situations.

Recruitment Process

FINAL FILING DATE: Applications must be received by County of Ventura Human Resources, Health Care Agency in Ventura, California, no later than 5:00 p.m. on Tuesday June 2nd, 2026.

To apply on-line, please refer to our website at www.ventura.org/hr . If you prefer to fill out a paper application form, please call (805) 677-5184 for application materials. Our address is: County of Ventura, Human Resources - Health Care Agency, 646 County Square Drive, Ventura, CA 93003.

NOTE: It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications. A resume and/or other related documents may be attached to supplement the information in your application and supplemental questionnaire; however, it/they may not be submitted in lieu of the application.

LATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here for additional information.

SUPPLEMENTAL QUESTIONNAIRE - qualifying: All applicants are required to complete and submit the questionnaire for this examination at the time of filing. The supplemental questionnaire may be used throughout the examination process to assist in determining each applicant's qualifications and acceptability for the position. Failure to complete and submit the questionnaire will result in the application being removed from consideration.

APPLICATION EVALUATION - pass/fail: An application evaluation will be conducted to determine whether or not each applicant possesses the required licensure, certification, and experience for this recruitment. Those candidates who meet the requirements will be placed on the eligible list.

Candidates successfully completing the examination process may be placed on an eligible list for a period of one (1) year.

BACKGROUND INVESTIGATION: A thorough pre-employment, post offer background investigation which may include inquiry into past employment, education, criminal background information, and driving record may be required for this position.

EQUAL EMPLOYMENT OPPORTUNITY
The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.

For more information about this recruitment, please contact Brett Ramirez by e-mail at [email protected] or by telephone at (805) 654-2277.

YOUR BENEFITS AS A COUNTY OF VENTURA EMPLOYEE

California Nurses Association

(CNA)

To learn more about Benefits, Retirement, and the Memorandum of Agreement (MOA), see links below.

• Benefits website or you may call (805) 654-2570.
• Retirement FAQ's
• Memorandum of Agreement

Union Code: NCN

Closing Date/Time: 6/2/2026 5:00 PM Pacific

Salary:

$124,664.15 - $149,057.66 Annually