RN II: Utilization Management Admissions Liaison

L.A. Care Health Plan

Los Angeles (CA)

On-site

USD 89,000 - 142,000

Full time

5 days ago

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Benefits offered by this job

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

L.A. Care Health Plan is seeking an RN II for Utilization Management Admissions Liaison to review admission and transfer requests in real-time and determine medical necessity using established criteria.

The role involves coordinating with inpatient teams, discharge planning, and collaborating with UM leadership to ensure timely decisions. The position requires an Associate's Degree in Nursing (Bachelor's preferred) with at least 7 years of acute-care experience, and strong computer literacy

Qualifications

Associate's Degree in Nursing required.
Bachelor's Degree in Nursing preferred.
Minimum 7 years of clinical experience in an acute hospital setting required.
Experience with Utilization Management/Case Management and discharge planning preferred.
Strong computer literacy with MS Office suite.

Responsibilities

Serve as the primary clinical contact for inpatient admission requests and HLOC transfers.
Determine medical necessity based on clinical criteria and timelines.
Coordinate with inpatient care teams for patient placement and transfers.
Support discharge planning and alternate levels of care coordination.
Communicate with UM leadership and other stakeholders to optimize processes.