Medical Care Coordinator

1 week ago


Rancho Cordova, California, United States Blue Shield of California Full time
Job Summary

We are seeking a highly skilled Medical Registered Nurse to join our Utilization Management team at Blue Shield of California. As a key member of our team, you will play a critical role in reviewing inpatient stays for our members and ensuring that the highest level of care is provided.

Key Responsibilities
  • Conduct thorough reviews of clinical information provided by inpatient facilities to determine medical necessity for our members.
  • Collaborate with healthcare providers and facilities to ensure that our members receive the most appropriate level of care.
  • Develop and implement effective discharge planning strategies to ensure that our members receive the necessary care and support after hospitalization.
  • Prepare and present cases to our Medical Director for review and approval.
  • Maintain accurate and detailed documentation of all cases and determinations.
Requirements
  • Bachelor's degree in Nursing or advanced degree preferred.
  • Strong communication and computer navigation skills.
  • Ability to work independently and as part of a team.
  • Excellent analytical and problem-solving skills.
What We Offer

We offer a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and detail-oriented Medical Registered Nurse looking for a challenging and rewarding role, we encourage you to apply.


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