We have other current jobs related to this field that you can find below
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Travel Nurse RN
1 month ago
Irvine, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 08/12/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...
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Travel Nurse RN
1 month ago
Irvine, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 08/12/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...
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Irvine, California, United States OptumCare Full timeOptumCare is a leading network of healthcare professionals dedicated to enhancing patient outcomes in the community. Our extensive network provides access to a wide range of specialists, hospitals, and urgent care facilities, ensuring comprehensive health solutions for our patients. The Pediatric Utilization Management RN plays a crucial role in overseeing...
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Travel Nurse RN
4 weeks ago
Irvine, United States KPG Healthcare Remote Work Freelance Full timeKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 9 hours, daysEmployment Type: Travel To work a contract with KPG Healthcare, a nurse must have two years of ...
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Travel Nurse RN
1 month ago
Irvine, United States KPG Healthcare Full timeJob DescriptionKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: 08/12/2024Duration: 13 weeks40 hours per weekShift: 9 hours, daysEmployment Type: Travel To work a contract with KPG Healthcare, a nurse must have two years...
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Travel Nurse RN
1 month ago
Irvine, United States KPG Healthcare Remote Work Freelance Full timeKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: 08/12/2024Duration: 13 weeks40 hours per weekShift: 9 hours, daysEmployment Type: Travel To work a contract with KPG Healthcare, a nurse must have two years of ...
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Travel Nurse RN
1 month ago
Irvine, United States KPG Healthcare Full timeKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: 08/12/2024Duration: 13 weeks40 hours per weekShift: 9 hours, daysEmployment Type: Travel To work a contract with KPG Healthcare, a nurse must have two years of ...
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Travel Nurse RN
4 weeks ago
Irvine, United States KPG Healthcare Full timeJob DescriptionKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 9 hours, daysEmployment Type: Travel To work a contract with KPG Healthcare, a nurse must have two years of ...
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Inpatient Utilization Management Nurse
3 hours ago
Irvine, California, United States OptumCare Full timeOptumCare is a leading organization that encompasses a vast network of healthcare professionals dedicated to enhancing patient care. Our extensive network provides access to a wide range of specialists, hospitals, and urgent care facilities, ensuring optimal health outcomes for our patients. The Pediatric Utilization Management RN plays a crucial role in...
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Utilization Management Registered Nurse
5 days ago
Irvine, California, United States OptumCare Full timeOptumCare is a leading organization in the health care sector, providing a vast network of physicians and health care professionals. Our extensive network ensures access to specialists, hospitals, urgent care, and more, facilitating optimal health outcomes. The Role of Utilization Management RN involves overseeing the inpatient Utilization Management...
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Pediatric RN for Utilization Review
3 hours ago
Irvine, California, United States OptumCare Full timeOptumCare is a leading organization in the health care sector, providing a vast network of physicians and health care professionals. Our extensive resources allow for seamless access to specialists, hospitals, and urgent care facilities, ensuring optimal health outcomes for our patients. The Role of Utilization Management RN involves overseeing the...
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Travel Nurse RN
1 month ago
Irvine, CA, United States KPG Healthcare Full timeKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 08/12/2024 Duration: 13 weeks 40 hours per week Shift: 9 hours, days Employment Type: Travel To work a contract with KPG Healthcare, a nurse must have two...
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Travel Nurse RN
1 month ago
Irvine, CA, United States KPG Healthcare Full timeKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 08/12/2024 Duration: 13 weeks 40 hours per week Shift: 9 hours, days Employment Type: Travel To work a contract with KPG Healthcare, a nurse must have two...
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Travel Nurse RN
4 weeks ago
Irvine, CA, United States KPG Healthcare Full timeKPG Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 9 hours, days Employment Type: Travel To work a contract with KPG Healthcare, a nurse must have two years...
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Irvine, California, United States OptumCare Full timeOptumCare is a leading organization in the health care sector, providing extensive support to physicians and health care professionals. Our network offers a wide range of resources, including specialists, hospitals, and urgent care facilities, ensuring optimal health outcomes for our patients. The Role of Utilization Management RN involves overseeing the...
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Travel Registered Nurse
1 month ago
Irvine, United States TravelNurseSource Full timeTravelNurseSource is working with Coast Medical Service to find a qualified Case Manager RN in Irvine, California, 92612!Pay Information$3,027 per weekAbout The PositionCoast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experienced or first-time traveler. Coast...
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Travel Nurse RN
1 month ago
Irvine, United States TRS Healthcare Remote Work Freelance Full timeTRS Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: 08/12/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelTRS Healthcare Job ID #1184524. Pay package is based on 8 hour shifts and 40 hours...
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Travel Nurse RN
1 month ago
Irvine, United States TRS Healthcare Full timeJob DescriptionTRS Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: 08/12/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelTRS Healthcare Job ID #1184524. Pay package is based on 8 hour...
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Travel Registered Nurse RN Care Management
1 month ago
Irvine, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California. Specialty: Case Management ~ Shift: 8 hours, days ~ Employment Type: Travel TotalMed Case Management Staffing Job ID #1584113. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with...
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Travel Registered Nurse RN Care Management
1 month ago
Irvine, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Irvine, California. Specialty: Case Management ~ Shift: 8 hours, days ~ Employment Type: Travel TotalMed Case Management Staffing Job ID #1584113. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with...
Case Manager Utilization RN- Per Diem
3 months ago
Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and other disciplines to coordinate a safe and acceptable discharge plan. Functions as an indirect caregiver, patient advocate and manages patients in the most cost effective way without compromising quality. Transfers stable non-members to planned Health care facilities. Responsible for complying with AB 1203, Post Stabilization notification. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment.
Essential Responsibilities:- Plans, develops, assesses and evaluates care provided to members.
- Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use.
- Recommends alternative levels of care and ensures compliance with federal, state and local requirements.
- Assesses high risk patients in need of post-hospital care planning.
- Develops and coordinates the implementation of a discharge plan to meet patients identified needs; communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies.
- Reviews, monitors, evaluates and coordinates the patients hospital stay to assure that all appropriate and essential services are delivered timely and efficiently.
- Participates in the Bed Huddles and carries out recommendations congruent with the patients needs.
- Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and obtaining all authorizations/approvals as needed for outside services for patients/families.
- Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient and non-KFH facilities.
- Acts as a liaison between in-patient facility and referral facilities/agencies and provides case management to patients referred.
- Refers patients to community resources to meet post hospital needs.
- Coordinates transfer of patients to appropriate facilities; maintains and provides required documentation.
- Adheres to internal and external regulatory and accreditation requirements and compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA and DOL.
- Educates members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources.
- Provides patients with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness.
- Per established protocols, reports any incidence of unusual occurrences related to quality, risk and/or patient safety which are identified during case review or other activities.
- Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources and participates in the collection and analysis of data for special studies, projects, planning, or for routine utilization monitoring activities.
- Coordinates, participates and or facilitates care planning rounds and patient family conferences as needed.
- Participates in committees, teams or other work projects/duties as assigned.
