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Pediatric Ambulatory Case Manager - Managed Care
10 Applications Submitted for this Position

Job Description

Ambulatory Case Manager, Manged Care

Pediatric experience, knowledge of CCS (California Children's Services)

Office Desk Job in San Fernando Valley

Monday through Friday; 40 hours per week (Full Time) Some OT may be require

Managed Care setting experience a must.  Understand all UR and UM guidelines

Good communication skill with Doctors, Nurses and Insurance Companies a must

Job Requirements

Knowledge of:

  • DRG and ICD-9 and CPT coding, requirements for prior approval.
  • Available community resources.
  • Local Referral Network
  • Effective charting practices and guidelines.
  • Reimbursement related to Medicare, Medi-Cal & Managed Care
  • California Nursing License (RN)

About Managed Care Resources:

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!


Case Manager  Impatient Utilization Review Utilization Management Discharge Planning CCM Certified Case Manager Ambulatory Clinical Hospital Chart Review INTERQUAL  Milliman DRG ICD Prior Auth Manage Care Complex Telephonic  Quality Supervisor Manager Director Charge ER Emergency Room Auditing  Grievance and Appeals Care Planning Plan of Care Care Management  Concurrent Review


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 15A*
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Pediatric Ambulatory Case Manager - Managed Care

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