Nurse Case Manager Specialist

3 weeks ago


Los Angeles, California, United States Pyramid Consulting Full time

Job Summary

We are seeking a dedicated Nurse Case Manager Specialist to join our team at Pyramid Consulting. The ideal candidate will have experience in coordinating patient admissions, discharge planning, and utilization management in an acute care setting.

About the Role

  • This position involves working closely with physicians and multidisciplinary teams to ensure seamless transitions for patients, making recommendations for alternative levels of care, and providing support to families and caregivers.
  • The successful candidate will play a key role in patient advocacy, ensuring high-quality care while maintaining cost-effective resource use.

Key Responsibilities

  1. Evaluate patient needs and develop comprehensive discharge plans with an interdisciplinary approach.
  2. Conduct utilization reviews to recommend alternative care options for optimal patient outcomes.
  3. Maintain regulatory compliance with healthcare regulations (TJC, Medicare, Medi-Cal) and documentation standards.

Requirements and Qualifications

  • Experience with InterQual, EPIC, and case management or utilization review.
  • Clinical assessment and discharge planning skills.
  • Ability to work effectively in a fast-paced environment.

Benefits

Paid sick leave, health insurance (medical, dental, vision), 401(k) plan, and a competitive hourly rate of $80-$85/hour.



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