RN Case Manager – Utilization Review
Shift: (08:00)
Contract Length: 12 weeks Guaranteed Hours: 40 hours per week
Roles & Responsibilities:
- Facilitate care along a continuum through effective resource coordination to support patients achieving optimal health and appropriate utilization of resources.
- Manage the medical necessity process to ensure accurate and timely payment for services, which may involve negotiation with payers on a case-by-case basis.
- Deliver Immediate Medical Notifications (IMMs) and Medicare Outpatient Observation Notices (MOONs) as required.
- Collaborate effectively with interdisciplinary teams to assess and coordinate care for patients transitioning from acute care to post-acute settings.
Location: San Ramon, CA