Registered Nurse (RN), Case Manager, Utilization Management - FT/Days
Company: MemorialCare Health System
Location: Laguna Hills
Posted on: June 12, 2021
Purpose Statement / Position Summary
The RN Care Manager is responsible for utilization review,
multi-disciplinary care coordination and transition planning, for
an assigned patient caseload. Role functions include: clinical
assessment, payor communication for needed authorizations, and
implementation of a patient / family centered plan of care across
the continuum, to ensure optimal patient outcomes, including safe
and timely transitions. The success of the department is inherent
in the individuals' ability to demonstrate positive, professional
communication with patients/families, physicians, and other
providers, and to meet / exceed benchmarks for quality outcomes,
and financial targets.
- Prefer minimum 2-3 years Acute Hospital Nursing and 1-2 years
Case Management and Utilization Review and Discharge Planning
- Milliman Care Guidelines utilization highly desirable.
- Current RN License in the State of California and BLS is
- Prefer: Bachelor's Degree in Nursing or higher.
- Certified Case Manager (CCM) highly desirable.
Keywords: MemorialCare Health System, Los Angeles , Registered Nurse (RN), Case Manager, Utilization Management - FT/Days, Other , Laguna Hills, California
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