Position Requirements Include: Certified by the Board of Nursing and has an active California license to practice. Minimum of 5 years primary care and comfortable with differential diagnosis. A caring and compassionate person who loves helping others.
Graduate of an approved program of Nursing. Active, unrestricted RN license in state of California. Experience in a managed care setting. Three years supervisory/management experience in a health care environment. Evidence of have attained certification in Case Management (CMC) (CCMC) or (CMAC)
Associate’s Degree or higher. 2+ year’s experience in either insurance or hospital UM or appeal experience. Strong acute Utilization Review experience. Experience with Milliman (MCG) or InterQual. RN licensure- Licensed to work California and Nevada payors.