California Licensed RN Care Manager
Get new jobs like this one by email. Create a free account for job alerts and to save the jobs you like.
Job Summary
To enhance patient care and resource utilization, the part-time California Licensed RN Care Manager in Utilization Management will conduct clinical reviews of acute medical patients, collaborate with healthcare professionals, and ensure compliance with insurance guidelines while working remotely.
Key responsibilities
- Completes clinical reviews of acute medical patients using the Optum/Inter Qual tool to assess treatment appropriateness and necessity
- Collaborates with healthcare providers to develop and implement comprehensive patient care plans, ensuring efficient communication among stakeholders
- Meets weekly productivity and quality audit metrics as defined in departmental goals
Required qualifications
- Associate's Degree in nursing or equivalent combination of education and related experience
- Five years of acute hospital experience, with preferred experience in critical care areas
- Two years of utilization review experience using the Optum/Inter Qual product within the last 12 months
- Registered Nurse (RN) licensure in the state of practice
- Bachelor's Degree in Nursing (BSN) is preferred
Complete Job Description
The complete job description is available to premium members. Premium membership includes:
Full access to 38,043 remote jobs from human-vetted companies, updated daily
Resume Builder - AI-powered tool to craft, enhance, and tailor your resume to a specific job
Twice-monthly live group coaching and the full Remote Career Center
20% member discount on Career Services
Backed by a 30-day money-back guarantee
Company Company Name
Headquarters Headquarters
Founded Founded
Website
Wikipedia Wikipedia URL
BBB URL BBB URL
The company description is available to premium members. Go Premium for full access to every job and company profile in our remote jobs database, backed by a 30-day money-back guarantee.
