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Date: 08/14/2009
Title: UM NURSE CASE MANAGER, RN
Category: Health Services/UM Department
Description: Sign-on bonus for RNs of $2000 UM Case Managers promote coordination and continuity of care and quality management in both inpatient and ambulatory care settings by the review of referrals and authorization of payment for specialty care and ancillary services. Case Managers evaluate the appropriateness of care using established criteria and Plan benefit guidelines. Reviews are conducted on a prospective, concurrent, and retrospective basis. Additional duties may include discharge planning and telephone triage functions.
Requirements: Possession of a valid California RN nursing license and three years (3) of full-time experience or its equivalent as a registered nurse or licensed vocation nurse in an acute care hospital, at least one year (1) of which was on a medical/surgical ward or unit; one year of previous UM/QM experience in a managed care setting preferred. Excellent written, verbal and interpersonal communication skills required.
