Case Manager, Full Time, Days Shift (8 hours)

Hemet Global Medical Center; Anaheim, Northern (CA, KY); Hybrid; USD 68,000 - 102,000; Full time

Job summary

Hemet Global Medical Center in Anaheim, CA seeks a Case Manager for the Day shift. The RN Case Manager reviews inpatient admission and continued stay criteria, and develops discharge plans. The role requires coordination with physicians, nursing and payers, and documenting reviews in the QRS system.

Requirements include a CA RN license, and familiarity with Interqual, Medicare and Medi-Cal regulations, plus strong written and verbal communication. Hospital experience is preferred.

Qualifications

• CA RN license required or equivalent.
• Recent acute hospital experience preferred.
• Knowledge of Interqual Criteria, Medicare, MediCal and Insurance regulations preferred.
• Good written and verbal communication skills mentioned in posting.

Responsibilities

• Review inpatients for admission criteria and continued stay criteria.
• Formulate discharge plan and interview patients and family members for discharge needs.
• Collaborates with physicians, nursing, ancillary staff and payers.
• Enter medical reviews into the QRS system.
• Document reviews for Medi-Cal, Medicare, IMS and cash as well as other financial classes.

Skills

Communication skills

Acute hospital experience

Interqual Criteria knowledge

Education

RN license

Tools

QRS system

Job description

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Case Manager, Full Time, Days Shift (8 hours)

Full-Time CASE MGR Anaheim, CA, US

Salary Range: $49.50 To $74.40 Hourly

The RN Case Manager is responsible for reviewing inpatients for admission criteria and continued stay criteria. Formulates discharge plan, interview patients and family members for discharge needs. Collaborates with physicians, nursing and ancillary staff as well as payers. Enters medical reviews into QRS system. Documents appropriate reviews for all patients, Medi-cal, Medicare, IMS and cash as well as other financial classes.

Requirements :

• CA RN license
• Recent acute hospital experience preferred
• Knowledge of Interqual Criteria, Medicare, MediCal and Insurance regulations preferred
• Good written and verbal communication skills