Job Openings in Sacramento County and Beyond
Nurse Case Manager - Direct Hire
Sacramento, CA | Direct Hire Position
Responsibilities: Proactively assesses all potential cases and actively manages all high risk, high volume cases. Performs care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. Researches and refers members to sources for alternative funding, community services and other services which may provide support to the patient and family. Identifies cases for possible peer reviewers toevaluate the appropriateness and necessity of care and or quality of care concerns. Assures referrals are complete and enrollment/eligibility benefits verified, prior to authorizing inpatient and outpatient care. May also refer tosocial worker, or other carve out services as needed. Completes appropriate, accurate and timely, documentation into EMR system. Travel is required.
Requirements: 2 years professional nursing experience in an acute care setting preferred or; 2 years' utilization/case management experience in the managed care industry. Medicaid experience a plus. Outstanding communication skills, both oral and written. Excellent active listening andcritical thinking and analytical skills. Demonstrated ability to solve mid-level problems with minimal supervision.Strong multi-tasker who can exercise excellent time management and meet multiple deadlines. Ability to exercise sound discretion and strict maintenance of confidentiality. Self-motivated with strong organizational, multi-tasking, planning, and follow up skills