- Hospital, Inpatient
- RN Case Manager, Care Coordinator
- 40 hours per week
Concurrent Review, Utilization Review, Discharge Planning
About the Job:
- Admitting new patients by reviewing records and applications
- Determine patient requirements by completing intake assessments. Level of care review.
- Establishes treatment programs; coordinating services being provided
- Maintains records by reviewing case notes; logging events and progress.
- Methods to resolve patient needs such as discharge planning, Home Health, DME and SNF’s.
- Identify potential quality issues, delays in service, post-acute care needs
- California Nursing License (RN)
- 2+ Years of Case Management Experience
- DRG and ICD-9 and CPT coding, requirements for prior approval.
- Available community resources. Local referral network
- JCAHO Standards and Title XXII Regulations
- InterQual or Milliman criteria experience
Managed Care Resources, Making Careers is a Health Care Staffing Agency in the niche fields of Case Management, Utilization Management / Review, Quality Management / Assurance and Performance Improvement. MCR, Making Careers has been servicing the State of California for the last 25 Years providing Medical Professionals to Hospitals, Medical Groups, IPAs, Health Plans, Healthcare Foundations, Home Health Departments, Medical Offices, Managed Care and Insurance Companies in search of both Permanent and Temporary Staff. Call: (310)-470-4232 or (800)-350-1471 for more information!