Case Manager - Registered Nurse (RN) - Hospital, Acute

1. Hospital - Inpatient, Case Manager
2. Concurrent Review, Discharge Planning
3. 40 Hours per Week

Ability to:  

• Provide concurrent review and analysis of inpatient records to determine if the patient's admission and continued acute stay flags any quality indicators.
• Coordinate chart reviews for quality reports and clinical procedures
• Process TARS as needed

Knowledge of:  

1. DRG and ICD-9 and CPT coding, requirements for prior approval.
2. Available community resources.
3. Effective charting practices and guidelines.
4. JCAHO Standards and Title XXII Regulations
5. Reimbursement related to Medicare, Medi-Cal & Managed Care

• California Nursing License (RN)

• 3+ Years of Case Management Experience
• DRG and ICD-9 and CPT coding, requirements for prior approval.
• Available community resources. Local referral network
• JCAHO Standards and Title XXII Regulations
• InterQual or Milliman criteria experience a plus

About MCR:

Managed Care Resources, Making Careers is a Health Care Staffing Agency in the niche fields of Case Management, Utilization Management / Review, Quality Management / Assurance and Performance Improvement. MCR, Making Careers has been servicing the State of California for the last 25 Years providing Medical Professionals to Hospitals, Medical Groups, IPAs, Health Plans, Healthcare Foundations, Home Health Departments, Medical Offices, Managed Care and Insurance Companies in search of both Permanent and Temporary Staff. Call: (310)-470-4232 or (800)-350-1471 for more information!