Rady Children's Hospital San Diego RN UM/Case Management/Capitation Nurse-50271 in San Diego, California
This is a Casual with an anticipated assignment length through January 31, 2019 and subject to renewal thereafter.
JOB SUMMARY:
Under the supervision of the UM/QI Supervisor and/or Manager and Compliance Liaison, the Utilization/Case Manager Nurse coordinates the delivery of care through assessment, planning, facilitation, and patient advocacy to ensure cost-effective, quality outcomes of care. The Utilization/Case Manager Nurse works with all members of the health care team to ensure optimal outcomes are reached while appropriate utilization occurs.
MINIMUM QUALIFICATIONS:
Associate's Degree or Nursing Diploma
Current California Registered Nursing Licensure
Three years of experience
Managed Care experience (will consider Hospital Case Management Experience)
Knowledge of common medical insurance operations
Strong mathematical and reasoning skills
PREFERRED QUALIFICATIONS:
Bachelor's Degree
Case Management Certification Experience
Pediatric Nursing Experience
Professional nursing certification