California Licensed Case Manager Nurse

A company is looking for a Case Manager Nurse.

Key Responsibilities

Conduct thorough assessments of patients' needs and develop treatment plans in collaboration with healthcare providers

Monitor interventions, evaluate treatment effectiveness, and maintain communication with patients and the multidisciplinary team

Document case management activities and perform Utilization Reviews for assigned members

Required Qualifications

Graduation from an accredited RN program and a current California RN license

Minimum of five years of medical / surgical or acute care experience, including two years in case management

Preferred experience in case management, emergency room, or critical care

Knowledge of medical claims and coding (ICD-10, CPT, HCPCS)

Experience in critically evaluating claims data and discharge planning