UR, Concurrent Review, Case Manager - Nurse (RN)

• California Nursing License (RN)
• 2+ Years of Inpatient Case Management Experience
• InterQual and/or Milliman criteria experience a plus

Knowledge of:

1. DRG and ICD-9 and CPT coding, requirements for prior approval.
2. Available community resources.
3. Local Referral Network
4. Effective charting practices and guidelines.
5. Reimbursement related to Medicare, Medi-Cal & Managed Care

About the Agency:

Managed Care Resources, Making Careers is a Health Care Staffing Agency in the niche fields of Case Management, Utilization Management / Review, Quality Management / Assurance and Performance Improvement. MCR, Making Careers has been servicing the State of California since 1987 providing Medical Professionals to Hospitals, Medical Groups, IPAs, Health Plans, Healthcare Foundations, Home Health Departments, Medical Offices, Managed Care and Insurance Companies in search of both Permanent and Temporary Staff. Call: (310)-470-4232 or (800)-350-1471 for more information!