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RN Utilization Review Manager

Company: Mindlance
Location: Sacramento
Posted on: April 9, 2021

Job Description:

RN Utilization Review ManagerAdvance your career with Mindlance! We have been connecting talented IT professionals with world-class companies since 1999. Mindlance is here to help you to find the perfect fit with just the right company. Currently, we are seeking a RN Utilization Review Manager for an exciting career growth opportunity.Make your next big career move with the kind of position that will allow you to be genuinely passionate about the work you do! Our recruiters will work closely with you to help you get the edge over the competition. Let Mindlance advocate for you - apply today!"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."RN Utilization Review ManagerJob Description: -- Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.Education/Experience: -- Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. -- 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. -- Knowledge of utilization management principles and healthcare managed care. -- Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.The position:-- Purpose of the position: Case Management is "de-delegating", m-- eaning that provider groups are no longer doing case management on the members. These temps will take that on-- Duties: Workers will be given a larger case load (minimum of 120) as "long term case management". Will be managing all members over time. They will not be discharging members. Workers will make calls to members based on acuity and needs. They will be handling post discharge members, members with chronic medical conditions, and coordination of care needs.RN Utilization Review ManagerJob Requirements:Training expectations:-- Expect the temps to be in the Woodland Hills office anywhere between 2-4 weeks (could change) for in person training-- All training will be completed remotely as much as possible while "Safer at home" orders are in place and as long as the company determines the need for staff to remain working from home.-- Will be centered around the Trucare system training and case management processes.-- Target candidates who live within 50 miles of the Woodland Hills officeGood focus areas:-- Med-Surg backgrounds (they've dealt with chronic conditions and manage a lot of patients)-- Home Health (they would be used to handling larger case loads and can work independently)Required Certifications: -- CA RN LicenseRN RN Utilization Review Manager

Keywords: Mindlance, Sacramento , RN Utilization Review Manager, Executive , Sacramento, California

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