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(RN) Registered Nurse Case Manager

(RN) Registered Nurse Case Manager

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Job Description


    Registered Nurse (RN) - Case Manager

    1.     Responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review.

    2.     Responsible for the assessment, facilitation, planning and coordination of medical care and services for patients to ensure appropriate treatment in the most cost effective manner

    3.     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)

    4.     Level of care and length of care reviews

    5.     Establishes treatment programs; coordinating services being provided

    6.     Monitors cases by observing and evaluating treatments and responses

    7.     Identify potential quality issues, delays in service, post-acute care needs

    8.     Pre-certification and Prior Authorization.

Job Requirements

    • California Nursing License (RN)

    • Previous Case Management Experience


Job Snapshot

Employment Type Contractor
Job Type Health Care, Management, Nurse
Education Not Specified
Experience Not Specified
Manages Others Yes
Industry Managed Care, Healthcare - Health Services
Required Travel Not Specified
Job ID 05A*
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(RN) Registered Nurse Case Manager

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