California Licensed Case Manager II

Job Summary

To enhance patient care and outcomes, the full-time California Licensed Case Manager II will conduct utilization management reviews, coordinate discharge planning, and facilitate post-acute care referrals while working onsite in Sacramento, California.

Key responsibilities

• Conduct preauthorization, concurrent, and retrospective utilization management reviews to ensure medical necessity and appropriate levels of care
• Coordinate resource management and discharge planning for patients with complex health needs
• Promote patient wellness and efficient utilization of health services through effective collaboration with healthcare teams

Required qualifications

• Associate Degree in Nursing from an accredited school
• Current RN license in California
• CCM certification preferred, with the requirement to obtain within 2 years of hire
• Minimum of 2 years of recent relevant experience in case management
• Comprehensive knowledge of Utilization Review and regulatory compliance in healthcare