RN Inpatient Case Manager

Medica is excited to share this TEMP opportunity with you! Our client is looking for a Remote RN Inpatient Case Manager with UM experience and Prior Auths to join their team!

REMOTE
Pay: $60hr

For immediate consideration, please submit your resume to: bchairez@medicatg.com

Overview:
The RN Inpatient Case Manager will provide daily care coordination with concurrent review for patient in the hospital or Skilled Nursing Facilities
(SNF) in person or telephonically. This position will also provide case management to patients who are admitted to the hospital and those
patients who may need to be enrolled in ambulatory case management.

Responsibilities for RN Inpatient Case Manager:
1. Responsible for daily concurrent reviews, retro reviews, discharge planning, pre-certification/prior authorization request review,
and ensures patients meet appropriate level of care based on acceptable evidence-based Clinical Criteria(s). (Interqual and / or
Milliman)
2. Follows established policies, procedures, workflows, and desktop procedures of the department.
3. Effectively and efficiently manages patients throughout the continuum of care.
4. Works collaboratively with hospitalists, hospital partners, and care teams to provide holistic patient care that is focused on high

Qualifications:
1. Graduation from an accredited nursing program.
2. Current valid License as a Registered Nurse through the California Board of Registered Nursing; Bachelor’s degree in nursing, or
another health or human services field with the appropriate licensure preferred.
3. Experience in and willingness to be part of multi-disciplinary team.
4. Experience with physically or mentally impaired adults and/or geriatric population.
5. Three years RN experience in public health nursing, acute care, case management and/or home health care required; minimum of 2
years of managed care experience in case management with focus in inpatient and/or outpatient ambulatory care preferred.
6. Bilingual in English and Spanish preferred.

Skills and Abilities:
1. Excellent customer service skills and ability to resolve complex customer service issues and exercise conflict management.
2. Ability to read, write and speak in a clear, accurate and professional manner; includes active listening skills and understanding
medical terminology.
3. Ability to complete basic/intermediate math computations and medical math conversions.
4. Proficient in beginning/intermediate computer skills and typing.
5. Excellent follow through skills, multi-tasking, prioritization and attention to detail

INDMED