UM Inpatient Review & Care Transition RN Job

UM INPATIENT REVIEW & CARE TRANSITION RN needed for a CONTRACT opportunity with Yoh's client located in South San Francisco, CA.

THE BIG PICTURE - TOP SKILLS YOU SHOULD POSSESS:

- Experience with Milliman and/or InterQual
- Knowledge of Medicare & Medi-Cal

WHAT YOU'LL BE DOING:

- Ensure that initial and concurrent reviews for all prospective and retrospective inpatient admissions are completed
- Identification and coordination of short- and/or long-term needs of catastrophically/chronically ill and/or injured persons and their families
- Coordination of clinical needs across the continuum of care by contacting and establishing links with physicians and other providers and community resources
- Work collaboratively with facility partners to evaluate and provide feedback to admitting physicians and Discharge Planning staff

WHAT YOU NEED TO BRING TO THE TABLE:

- Current California RN license
- Certification as CCM (Certified Case Manager) or equivalent is preferred
- Bachelor's degree in Nursing or related field is a plus
- Knowledge of case management principles and practices and managed care processes, including use of Milliman Care guidelines or InterQual
- Knowledge of Medicare and Medi-Cal benefits

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER:Jennifer Andersen

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Contact us if you are an individual with a disability and require accommodation in the application process.

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