Shift: Days
Job type: Full Time
Hours: 0800-1630
Schedule: 10 shifts per two week pay period. Every other weekend required.
Up to $25,000 Sign-On bonus based on experience!
The scope of duties encompasses a variety of tasks related to performing the following: integrated concurrent review for utilization; quality and risk; discharge planning; and case referrals for patients. This position works with medical and professional staffs to obtain appropriate clinical documentation for review and to meet inpatient criteria by the Interqual Guidelines. The Case Managers are responsible for the research and appeal UR denials; micro management of patients to ensure appropriate and timely resource utilization; timely and accurate communication to insurance utilization review for certification of admission and continued stay.
1. Current license as a Registered Nurse in California, or related health care professional
2. Three (3) years Case Management/UM experience in an acute care facility
3. CPR
4. Knowledge and experience with Medi-Cal - preferred
5. Good communication skills and ability to work with others
6. Basic computer skills
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