California Licensed Care Review Clinician

Job Summary

A company is looking for a Care Review Clinician II to assist with discharge planning for healthcare members.

Key Responsibilities

• Work with CA hospitals and lower levels of care to ensure safe discharges for Health Plan members
• Utilize MCG criteria to facilitate appropriate transitions of care
• Collaborate with healthcare providers to create seamless care transitions

Required Qualifications

• Minimum 5 years of clinical experience as an acute care nurse in med-surg, tele, ICU, or ER settings
• At least 2 years of experience as a hospital-based discharge planner
• Strong understanding of Medi-Cal post-acute care benefits
• Experience with MCG inpatient criteria and facility contracts for post-acute care
• Must be a licensed RN in California