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Utilization Management Nurse Case Mgr/Care Cord.
- This position is responsible for coordinating various aspects of medical case management and utilization management to ensure quality cost-effective care for specific populations, both in-patient and out-patient. The successful candidate will be a graduate from an accredited school of nursing and possess a current, unrestricted California State license with a minimum of 2 years professional nursing in a clinic or hospital environment and 3-5 years case management, home health and/or disease management preferred. Must have a commitment to excellent customer service, be highly organized, ability to do occasional physician office visits with patients and be computer literate.
- Experienced individuals can apply for positions in any facet of running a primary care physician office for "on call" work in several locations in the Central San Joaquin Valley.
Nurse Case Manager
- Full-time career opportunity for a qualified Nurse Case Manager responsible for coordinating various aspects of medical case management and utilization management to ensure quality, cost-effective care for specific populations, both inpatient and outpatient. The successful candidate will be a graduate from an accredited school of nursing and possess a current California State Registered RN license with a minimum of one year professional nursing experience in a clinic or hospital and 3-5 years case management experience preferred. Must have a commitment to excellent customer service, be highly organized and computer literate
- This position is responsible for insurance and patient balance follow-up, aging reports, refunds and customer service. Job qualifications: high school diploma or GED required. Necessary 3 years medical billing insurance follow-up experience, Required knowledge of Medicare, HMO, PPO and other state programs. Required Knowledge of ICD-9, CPT and HCPC coding. Knowledge of E & M codes a plus. Spanish bilingual a plus
- Per diem & Full-Time opportunities. Must be licensed wtih some Oncology background.