California Licensed Care Manager

Job Summary

Facilitating utilization management processes, the full-time California Licensed Care Manager will evaluate appropriateness of admissions, ensure timely patient transitions, and coordinate care with treatment teams while working remotely.

Key responsibilities:

• Conduct concurrent reviews to assess the appropriateness of admissions and levels of care
• Resolve care transition delays and collaborate with the Facility Acute Care Manager
• Provide clinical information to third-party payers to ensure reimbursement

Required qualifications:

• Graduate of an accredited school of nursing
• RN-Registered Nurse license in California upon hire
• Minimum of 2 years of relevant experience in utilization management or case management
• Knowledge of healthcare reimbursement systems and regulatory compliance
• Proficiency in using computer software, including Microsoft Office Suite