Registered Nurse Case Manager (RN)

Job description

Shift : Days Job type: Full Time: Hours: 0800-1630: 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 #LI-DH1  Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At John F. Kennedy Memorial Hospital hospital, were seeking...