RN Case Manager

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description -100% Telephonic *Excellent benefits, PTO-3 weeks’ vacation 1st year –Kick in 1st of the month after they are hired! Position Purpose: Perform collaborative duties to assess, plan and coordinate continuum of care for select members at high risk in order to promote quality, cost effective programs. Position Responsibilities: Advanced review of admissions through and telephonic review to ensure medical necessity and appropriate level of care. Develop, assess and adjust as necessary the care plan and promote desired outcome. Coordinate services between Primary Care Physician (PCP) specialist, and other medical and non-medical providers as necessary to meet the complete medical socio economic needs of clients. For BCHP only, participate in face to face visits with high risk members at point of service. Provide patient and provider education. Identify related risk management quality concerns and report these scenarios to the appropriate resources. Data enters assessments and authorizations into the system. Qualifications RN License At least two years clinical nursing experience. At least two years’ experience coming from a managed care environment OR an environment where they are dealing w/ Medicare population-such as govn't funded clinic where they are assisting patients & completing paperwork and eligibility for gov't services/ will take candidates straight from clinical Computer Savvy (if your candidates last position was at a skilled nursing facility make sure they were dealing with EMR) California has hired on personality in the past, great personality will go a long way** Preferred but not a must - Candidates who have Medical Website experience or CCS (California Children’s Services) Experience Additional Information Are you an experienced RN Case Manager looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you! Interested in hearing more about this great opportunity? Reach out to Ashley Greener at View phone number on click.appcast.io for immediate consideration. #J-18808-Ljbffr