California Licensed RN Care Manager

Job Summary

A company is looking for an RN, Care Manager, Utilization Management (Full-Time, Remote).

Key Responsibilities

• Completes clinical reviews of acute medical patients to assess treatment appropriateness and length of stay
• Collaborates with healthcare professionals to develop comprehensive patient care plans and facilitate communication among stakeholders
• Stays updated on healthcare regulations and guidelines to ensure optimal service delivery and participates in required training

Required Qualifications, Training, and Education

• Associate's Degree in nursing or equivalent combination of education/related experience: Required
• Bachelor's Degree in Nursing (BSN): Preferred
• Five years' acute hospital experience required, preferably in critical care areas
• Two years' utilization review experience using the Optum/Inter Qual product within the last 12 months: Required
• Registered Nurse (RN) licensure in the state of practice: Required