RN Case Manager: Pre-Admit & Care Coordination

AHMC Healthcare Inc.; Anaheim (CA); Vor Ort; USD 90.000 - 120.000; Vollzeit

Zusammenfassung

AHMC Anaheim Regional Medical Center is seeking an experienced RN Case Manager to oversee discharge planning, care coordination and utilization management across AHMC's acute care services. You will assess patient needs, determine appropriate level of care, and collaborate with the care team to optimize outcomes.

Using Milliman & Robertson and InterQual criteria, you will ensure appropriate admissions and reads, support performance improvement goals, and communicate effectively with social

Qualifikationen

• 2+ years Utilization Management/Case Management experience preferred in acute care.
• Working knowledge of InterQual criteria and related utilization management.
• Strong communication and problem-solving skills.
• Ability to coordinate care across multidisciplinary teams.
• Understanding of Medicare, Medi-Cal and Managed Care reimbursement.

Aufgaben

• Evaluate admissions and discharge readiness using Milliman & Robertson and InterQual.
• Coordinate care plans with social workers, nursing staff and Medical Staff.
• Support mission and performance improvement initiatives.
• Ensure correct level of care across units and patient populations.

Kenntnisse

Case management

Utilization review

Discharge planning

InterQual criteria

Collaboration

Regulatory knowledge

Ausbildung

RN License - California

BSN preferred

Certified Case Manager preferred

Jobbeschreibung

AHMC Anaheim Regional Medical Center is seeking an experienced RN Case Manager to oversee discharge planning, care coordination and utilization management across AHMC's acute care services. You will assess patient needs, determine appropriate level of care, and collaborate with the care team to optimize outcomes.

Using Milliman & Robertson and InterQual criteria, you will ensure appropriate admissions and reads, support performance improvement goals, and communicate effectively with social