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Utilization Management Case Ma...
UTILIZATION MANAGEMENT CASE MANAGER RN
**SIGN ON BONUS $2,000**
Kern Health Systems is the largest health plan in Kern County serving over 140,000 local members. KHS is committed to providing quality health care to our members. Located in Bakersfield, California, we are nested in Central California where you greet each day with a smile. KHS also cares for our community and it is important to us as an organization to hold high standards when it comes to quality health care for our members. If you want to build a career in an organization that is dedicated to our community and the people that live here… then come see if you can meet the challenge by making us your first career choice!
Under the direction of the Kern Health Systems (KHS) Director of Health Service the U.M. Case Manager RN will promote coordination and continuity of care and quality management in both the inpatient and ambulatory care settings by the review of referrals and authorization of payment for specialty care and ancillary services. The review will evaluate the appropriateness of care using established criteria and Plan benefit guidelines. Review will be conducted on a prospective, concurrent, and retrospective basis. The UM Case Manager manages the required caseload on a monthly basis. Additional duties may include discharge planning and telephone triage functions.
The UM Case Manager RN is the entrance level classification in this series. Incumbents are expected to apply knowledge gained in a clinical practice to patient care situations which may be affected by regulatory constraints. The UM Case Manager RN is expected to gain full working knowledge of applicable regulations and to develop knowledge of health care delivery systemsand HMO regulatory requirements, including DMHC and CMS compliance. Assignments are subject to close review and evaluation while in progress and upon completion.
**SIGN ON BONUS $2,000**
We have an excellent benefit package which includes: health insurance, dental, vision, life, 457(b) and 401(a) Plan, and other benefits.
If you want to learn more about this great opportunity please visit our web-site at kernhealthsystems.come or come by our Human Resources Department, 9700 Stockdale Hwy. Bakersfield, CA 93311, Fax #661-664-4310, business hours are Monday thru Friday 8:00am to 5:00pm- or email: email@example.com When you reply send us your resume and include your salary history.
NOTE: As a condition of employment, a satisfactory drug test and background check is required.
keywords: PEDS, RN, Healthcare, Inpatient, Ambulatory, Case Manager