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Registered Nurse, Utilization Management/Quality Improvement (UM/QI) - Capitation

San Diego, California Apply
Job ID 1723 Date posted 02/10/2019 Schedule Full-Time Shift Temporary Hours Full-Time Department Nursing; CHOC MSO

JOB SUMMARY:

Under the supervision of the UM/QI Supervisor and/or Manager & Compliance Liaison, the Utilization/Case Manager Nurse coordinates the delivery of care through assessment, planning, facilitation, & 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

3 years of experience

California RN License

Knowledge of common medical insurance operations

Managed Care experience (will consider Hospital Case Management Experience)

Strong mathematical and reasoning skills

PREFERRED QUALIFICATIONS:

Bachelor’s Degree

Pediatric Nursing Experience

Case Management Certification Experience

POSITION DETAILS:

Schedule: Day Shift, 8 hour shifts

FTE:Full-time/Benefit Eligible

Location:CHOC Administration

Contract: Casual position, contracted through 02/28/2020 and is subject to renewal thereafter

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  • Nursing, San Diego, California, United StatesRemove
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