High Intensity Case Manager (RN or LVN)

Orange, CA 92868

Post Date: 06/12/2018 Job ID: 42946 Profession: LVN Case Manager

Have a passion for people and healthcare? Would you like to work for a company in Orange that has a 30-year history of successfully supporting its members and management? Immediate openings available for High Intensity Case Manger (RN or LVN) in their central Orange County office. Fun environment with staff events, employee performance recognition programs, promotion potential in a variety of departments, and amazing benefits!

Job Activities:

  • Reviewing cases for clinical necessity
  • Reviewing cases to insure all guidelines were met for insurance companies
  • Confirming proper eligibility and authorizations were received
  • Reviewing denials and correcting language for appeals
  • Reviewing referrals received
  • Researching cases and steps taken
  • Generating reports on various cases
  • Suggesting corrections for future issues and cases
  • Communicating with Physicians as needed
  • Abstracting and reviewing charts
  • Insuring timelines were met for authorization processes
  • Assisting with other projects as needed

Requirements:

  • Unrestricted/Active CA LVN or RN
  • 2+ years experience in Ambulatory Case Management
  • Strong Clinical Background
  • Experience developing care plans and completing comprehensive assessments

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