Rady Children's Hospital San Diego RN UM/Case Management/Capitation Nurse-50271 in San Diego, California

RN UM/Case Management/Capitation Nurse-50271

Job ID 125 Date posted 04/16/2018 Schedule Full-Time Shift Temporary

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