Case Manager – Case Management
Seven Healthcare are seeking an experienced Case Manager specializing in Utilization Review for a facility in Torrance, CA. This role involves working closely with the Director of Case Management to review and manage patient care and documentation. The successful candidate will possess the necessary qualifications to operate within a dynamic healthcare environment.
Seven Healthcare prioritize support, communication, and a nurse-first approach, ensuring that you can focus on providing excellent care. Our benefits include:
- License reimbursement – financial support to maintain your professional credentials.
- Referral program – earn rewards for introducing fellow healthcare professionals.
- Health insurance – comprehensive medical coverage for you and your family.
- Certification reimbursement – assistance with obtaining additional qualifications.
- Weekly pay – prompt and reliable payments every week.
Key Responsibilities of the Case Manager:
- Perform chart reviews and quality assessments using InterQual criteria.
- Identify and implement Case Management interventions with unpredictable outcomes.
- Monitor activity of 23-hour observation cases to ensure timely discharge or necessary admission.
- Initiate Medi-Cal TARs and document daily using established criteria.
- Evaluate the Case Management Plan during changes in patient care.
- Educate physicians and hospital personnel on Utilization Management criteria.
- Provide and deliver denial letters as directed.
- Research and prepare appeals for denial claims.
- Utilize innovative problem-solving skills in complex situations.
- Identify and refer inappropriate bed utilization and quality of care issues.
Requirements of the Case Manager:
- Current California RN license.
- Two years of clinical experience.
- Two years of Case Management experience or certification in Case Management.
- Current BCLS certification.
Torrance: Where the Job Meets Lifestyle
Located in Southern California, Torrance offers a vibrant coastal lifestyle with easy access to beautiful beaches, diverse culinary experiences, and a variety of recreational activities. Enjoy a perfect blend of work and leisure in this dynamic city.
Why Work with Seven Healthcare?
Seven Healthcare is a trusted staffing agency with 5-star ratings on Google and Vivian and recognition as a Best Travel Nurse Company 2024 by BluePipes. We offer competitive compensation, personalized support, and flexible job opportunities tailored to your career goals.