California Licensed Outpatient RN Case Manager

Job Summary

A company is looking for an Outpatient RN Case Manager.

Key Responsibilities

• Reviews authorization requests for medical necessity and documents the process
• Processes medical necessity denials and refers them to the physician for review
• Coordinates with health plans for expedited appeals and maintains compliance with standards

Required Qualifications

• Graduation from an accredited school of nursing
• Active, unrestricted Registered Nurse license through the State of California
• 1+ years of experience in case management or utilization review in a clinical setting
• Proficient with computers and Microsoft Windows environment
• Reside in the San Diego, CA area