Case Manager RN

New

A Case Manager RN position is available through Adecco Medical and Science with one of the leading health plan providers in Woodland Hills, CA! You will be responsible for working on complex cases that promote the delivery of quality, cost effective health care service based on medial necessity and contractual benefits. You must an active CA RN license and prior experience with Utilization Managment.

Case Manager RN Job Responsibilities include:

Collaborates with other members of the health care team, providers, hospitals, IPA/MGs, members and their families.
Discharge planning for cases that exceed EOA or dx assigned to EN
Follow up with LLC coordination such as SNF, HH, HI, Rehab.
Referrals to QM, DM, CM, and AGD.
IPA oversight, Continuity of Care, Health Family activities, OOA/OON cases, invest/ exp, POS.
Review medical necessity, intensity of services, level of care, length of stay and general appropriateness of care.
Provides guidance to provider network.
Performs effective discharge planning and collaborates with member support system and health care professionals involved in the continuum of care.
May provide case management to member segments with chronic or catastrophic illness

Qualifications:

Active CA RN License
Prior experience in acute care and utilization management


If you are interested in this Case Manager RN in Woodland Hills, CA then please click APPLY NOW. For other opportunities available at Adecco Medical and Science go to www.adeccousa.com. If you have questions about the position or would like more information, please contact Kayla Hanscom at 650-745-3112 or by email at Kayla.Hanscom@adeccona.com.
Equal Opportunity Employer.

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Reference number US_EN_2_108218_332572