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Job 25565


Location:
San Diego, CA

Job Title:
RN Case Manager_Rev Cycle(Children's Way)

Employment:
Long Term Temp (> 30 Days)

Description:

A large healthcare organization in San Diego seeks an RN Case Manager in Utilization/ Revenue Cycle department. They would like someone who has strong utilization experience someone who can facilitate authorization & reimbursement for inpatient hospital stays, coordinating discharge needs & providing information to the Quality department for collaborates with the health care team to facilitate appropriate movement along the continuum of care from inpatient admission to discharge.  

Their focus includes providing clinical documentation to third party payers to facilitate authorization & reimbursement for inpatient hospital stays, coordinating discharge needs & providing information to the Quality department for collaborates with the health care team to facilitate appropriate movement along the continuum of care from inpatient admission to discharge.

Requirements:

  • Bachelor's Degree (Minimum)
  • 3 years of experience (Minimum)
  • 4 years of experience (Preferred)
  • California RN License (Minimum)

MUST HAVES:

  • Reviews patient chart, prepares concise & accurate utilization summary to include history, status, plan of care, level of care & expected length of stay for third-party payers.
  • Makes referrals for patients with CCS-eligible diagnoses.
  • Identifies potential funding issues & notifies Financial Counselors & Sr Management as appropriate.
  • Utilizes Interqual criteria to determine correct level of care & patient placement.
  • Communicates with team if criteria is not met.
  • Must have utilization management experience Case Managers function as liaisons between patients, their families & internal & external health care personnel to ensure appropriate, efficient & timely health care service.

  

On Call Staffing Solutions, Inc. is an Equal Opportunity Employer – Minority/Female/Disability/Veterans



Minimum Years of Experience:
3

Degree Requirements:
BS

Pay Rate:
43.00




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