Español Text Only Version Careers Current RFP Contact Us
Kern Family Health Care
Print Share Text Size
Home Potential Members For Members For Providers About Kern Health Systems
About Kern Health Systems
Governing Board & Committees
Leadership Team
Code of Conduct
Request for Proposal
News Room
Why Work Here?
Career Areas
KFHC Grant Programs
Contact Us
Case Mananger RN Facility Based

UM Case Manager RN Facility Based

Under the direction of the Kern Health Systems (KHS) Medical Director and Director of Health Service the U.M. Case Manager will promote coordination and continuity of care and quality management in both the inpatient and ambulatory care settings by the review of referrals and authorization of payment for specialty care and ancillary services. The review will evaluate the appropriateness of care using established criteria and Plan benefit guidelines. Review will be conducted on a prospective, concurrent, and retrospective basis. The UM Case Manager manages the required caseload on a monthly basis. Additional duties may include discharge planning and telephone triage functions.

Requirements: Minimum of two years (2) full-time experience or its equivalent as a nurse in an acute care hospital, at least one (1) of which was working within a medical/surgical ward or unit. (E)
One (1) year of previous UM/QM experience in a managed care setting preferred. (D)
Bachelor’s Degree in Nursing, Health Administration or
related healthcare field preferred.(D)
Registered Nurse with an active, current, unrestricted license (E)
Valid California Driver License (E)
Bilingual preferred (D)