Offer summary
Qualifications:
Two years of Utilization Management experience, Active California Registered Nurse (RN) license, Knowledge of evidence-based clinical criteria, High school diploma or GED required, Valid California Driver's license and insurance.
Key responsabilities:
- Perform concurrent and retrospective reviews for medical necessity
- Collaborate with coordinators for care transitions
- Ensure effective communication among hospitals and IPAs
- Oversee discharge planning and medication reconciliation
- Prepare documentation on quality of care issues