California Licensed Case Manager Nurse

Job Summary

A company is looking for a Case Manager Nurse - Part Time.

Key Responsibilities

• Conduct thorough assessments of patients' needs and develop treatment plans
• Monitor treatment effectiveness and maintain communication with patients, families, and healthcare providers
• Document case management activities and perform utilization reviews for assigned members

Required Qualifications

• Graduation from an accredited RN program with a current California RN license
• Minimum of five years of medical/surgical or acute care experience, including two years in case management
• Preferred experience in case management, emergency room, or critical care
• Knowledge of medical claims and coding (ICD-10, CPT, HCPCS)
• Experience in critically evaluating claims data and discharge planning