To enhance patient care and resource utilization, the part-time California Licensed RN Care Manager in Utilization Management will conduct clinical reviews of acute medical patients, collaborate with healthcare professionals, and ensure compliance with insurance guidelines while working remotely. Key responsibilities Completes clinical reviews of acute medical patients using the Optum/Inter Qual tool to assess treatment appropriateness and necessity Collaborates with healthcare providers to develop and implement comprehensive patient care plans, ensuring efficient communication among stakeholders Meets weekly productivity and quality audit metrics as defined in departmental goals Required qualifications Associate's Degree in nursing or equivalent combination of education and related experience Five years of acute hospital experience, with preferred experience in critical care areas Two years of utilization review experience using the Optum/Inter Qual product within the last 12 months Registered Nurse (RN) licensure in the state of practice Bachelor's Degree in Nursing (BSN) is preferred
California Licensed RN Care Manager in workfromhome at Unknown Company
- Typical pay
- $86,320–$130,102
For context, most registered nurses earn between $86,320–$130,102 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as part time and able to be worked remotely.