California Licensed RN Care Manager
Job Summary
A company is looking for an RN, Care Manager in Utilization Management.
Key Responsibilities
- Completes clinical reviews of acute medical patients to assess treatment appropriateness and length of stay
- Collaborates with healthcare professionals to develop and implement comprehensive patient care plans
- Stays updated with healthcare regulations and insurance guidelines to ensure optimal service delivery
Required Qualifications
- 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, with preferred experience 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
COMPLETE JOB DESCRIPTION
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