We are working with a very reputable facility located in Los Angeles, CA.
Registered Nurse (RN) Case Manager
Full Time Direct Hire Position
Bilingual in Spanish is a plus but not mandatory
Incredible Benefits, 401K, Paid Time Off, Life Insurance, Medical, Dental, Vision, Empolyee Discount Programs, Great Vacation Time, Many Newly Staffed Team Members with a positive environment
Collaborating with the Utilization Management staff, Management, and off staff memebers
Documentation of all interactions with patients and all other efforts to provide care management and coordination while utilizing the care management database system.
Delivering patient-centered services that focus on addressing health , engagement and retention care, completion of medical needs, ensuring that needed consultations/procedures/appointments are scheduled, monitored for completion.
Work actively with all referring sites and contracted personnel to help them understand the clinical rationale, guidelines, and how to best utilize funds and services.
Managed Care Experience Preferred
Must be a Registered Nurse (RN)
Case Management Experience Required
Certified Case Manager (CCM) preferred
Claims Examiner Healthcare Non-Clinical Non Clinical Case Manager Inpatient Utilization Review Utilization Management Discharge Planning CCM Certified Case Manager Ambulatory Clinical Hospital Chart Review INTERQUAL Milliman DRG ICD Prior Auth Manage Care Complex Telephonic Quality Supervisor Manager Director Charge ER Emergency Room Auditing Grievance and Appeals Care Planning Plan of Care Care Management Concurrent Review
Associated topics: care, ccu, coronary, intensive, intensive care, intensive care unit, maternal, nurse, registed, registered nurse
• Post ID: 145366247 losangeles