Location: Los Angeles, CA Description:
The Judge Group is looking for a full time REMOTE Utilization Review/Case Management RN for a fantastic healthcare company in California!!
Please see below a brief overview of the position:
Performs prospective, concurrent and retrospective utilization Reviews and first level determination approvals for members Based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare and FEP.
Conduct UM/care management (CM) review activities with delegated entities as necessary. Manages member treatment in order to meet Recommended Length of Stay.
Ensures discharge(DC) planning at levels of care appropriate for the member’s needs and acuity.
Determines discharge (DC) plan by assessing cognitive and physical status.
Determines post-acute needs of patient, levels of care, equipment, how event is going to impact patient’s status.
Ensures quality, cost-effective DC planning.
Triages and prioritizes cases to meet required turn-around times.
Candidates must have an active RN license in the state of California in good standing!
Experience helpful but will train the right person!!
If you would be interested to apply, please send your most updated resume to me at jmaybrier@judge.com I would be happy to answer any questions you might have as well!
Thank You,
Jacob
Contact: jmaybrier@judge.com This job and many more are available through The Judge Group.
Find us on the web at www.judge.com