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Healthcare Advocate

2 months ago

Mission Viejo, California, United States Mission Regional Medical Center Full time
Job Summary

Mission Regional Medical Center seeks a skilled Healthcare Advocate to join our team. As a key member of our healthcare team, you will be responsible for ensuring the quality and resource management of all patients admitted to our facility.

Responsibilities
  • Conduct comprehensive admission and concurrent reviews of medical records to ensure medical necessity, intensity of service, and severity of illness.
  • Develop and implement cost-effective care plans that promote quality outcomes and seamless delivery of care.
  • Collaborate with healthcare providers to integrate care and achieve clinical and cost-effective outcomes.
  • Maintain accurate and detailed records of patient care and outcomes.
Qualifications
  • Minimum 5 years of work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
  • Grandfathered prior to April 1, 2015, or minimum 5 years post-graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
  • Five years of acute care nursing experience preferred, as well as at least one year of experience in case management, discharge planning, or nursing management.
  • Current BCLS (AHA) certificate upon hire and maintain current.
  • Knowledge of Milliman Criteria and InterQual Criteria preferred.
What We Offer

Mission Regional Medical Center is an award-winning team of dedicated professionals committed to our core values of quality, compassion, and community. We offer a dynamic work environment, opportunities for growth and development, and a comprehensive benefits package.