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Case Manager - Registered Nurse (RN) - Discharge Planner


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Job Description

RN Case Manager - Inpatient - Medical Center

About the Job:

  • Responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review.
  • Concurrent Review, Utilization Review, Discharge Planning
  • Using InterQual or Milliman criteria for medical necessity to determine if the patient is in the correct hospital setting and continued stay meets guidelines (S/I and I/S)
  • Level of care and length of care reviews
  • Establishes treatment programs; coordinating services being provided
  • Monitors cases by observing and evaluating treatments and responses
  • Identify potential quality issues, delays in service, post-acute care needs

Job Requirements

  1. Medicare and MediCal Utilization Management knowledge. 
  2. Excellent organizational skills.
  3. Ability to successfully work with various levels of professional staff
  4. Must be able to work independently and as part of a team.
  5. California Nursing License (RN)

About the Agency:

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 since 1987 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!

Job Snapshot

Employment Type Full-Time
Job Type Health Care, Nurse, Insurance
Education Not Specified
Experience Not Specified
Manages Others No
Industry Managed Care, Healthcare - Health Services, Insurance
Required Travel None
Job ID 23A*
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Case Manager - Registered Nurse (RN) - Discharge Planner

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