This is a fully remote position, open to applicants in California.

📋 Description

• Execute comprehensive case management tasks for designated patients.

• Organize, coordinate, negotiate, obtain, and oversee the care and requirements of complex patients and their families throughout the entire care continuum.

• Maintain daily communication with medical personnel, hospital staff, and external resources.

• Ensure the effective use of resources in line with clinical and financial guidelines.

• Review medical records for discrepancies in clinical and financial criteria.

• Take action to achieve the best possible outcomes for patients and the hospital.

• Utilize knowledge of risk management and infection control to promote favorable healthcare results.

• Recognize issues that may expose the organization to liability and financial risks.

• Work collaboratively with management, medical staff, and hospital personnel to reduce risks.

⛳️ Requirements

• Associate's degree in nursing or a nursing diploma required upon hiring.

• California Registered Nurse License needed upon hiring.

• Minimum of 2 years of acute care experience in a Medical Surgical or Inpatient environment.

• At least 1 year of experience in care management or utilization review in any setting, OR successful completion of TIPS program or Case Management Orientation Program required upon hiring.

• Bachelor's degree in nursing or higher preferred within 3 years of hiring.

• Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred.