A healthcare company is seeking a Telecommuting Senior Case Manager Registered Nurse. Core Responsibilities of this position include: Managing network participation, care with specialty networks, care with DME providers and transfers. Recommending services for Plan members.
Travel locally. Must have a valid Driver's License and CA Auto Insurance. California Registered Nurse (RN) license. 2+ years clinical nursing experience. Workers's Compensation Case Management experience or fluent in Spanish. Ability to use Microsoft Word and Excel efficiently.
Registered Nurse. Knowledge and experience with national clinical criteria applied in case management. Working knowledge of billing codes, Revenue Codes, and CPT. Experience and knowledge of managed care contracts. Other requirements as outlined in the job description.
A healthcare company is in need of a Telecommute Orthopedic Surgeon Utilization Review Physician in Sacramento. Must be able to: Telephonically contact providers and interact with other health professionals in a professional manner.
BSN or higher. Have either a current, valid, unrestricted independent license in behavioral health or nursing. Valid California State Clinical License required (RN, LCSW, MFT, LPCC, PhD or PsyD) Minimum of five (5) years of combined direct behavioral health clinical and managed care experience.
An insurance company is in need of a Telecommuting Inpatient Case Management Medical Director. Candidates will be responsible for the following: Supporting staff to manage inpatient care utilization at a hospital, market, regional or national level.
Qualifications for this position include: Education MA/MS. Independent behavioral health licensure valid in State of California: (LCSW, LPCC, LMFT) One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LPC, RN or LPN.
A for-profit health insurance company has an open position for a Telecommute Medical Director. Core Responsibilities of this position include: Providing medical interpretation and decisions about the appropriateness of services provided.