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Job Field: Office Jobs
Location: Rancho Mirage, CA
Salary: $Not stated

JOB SUMMARY:

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<tr><td valign="top" width="450"><b>Admissions Case Manager RN - Case ManagementDepartment: Case Mgmt/Social ServicesStatus: Full TimeShift: VariesHours Per Shift: 12 Hour ShiftJob Details: * Job Objective: The position is responsible for evaluating the medical necessity for admission and appropriateness of patient care unit placement for all scheduled admissions, direct admits, transfers, and outpatient conversions and provides consultation to physicians prior to patient placement.Licensure/Certification Required: CA RN LicenseExperience Required: Minimum 3 Years Recent Acute Care Hospital Case ManagementSkills, Knowledge and Abilities Required:Strong clinical and critical thinking skills and ability to establish and carry out complex plans of care for key diagnoses<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />Knowledge of regulations, standards and legislation (local, state and federal) related to the continuum of care and patient transitionKnowledge of the various health care delivery systems and payer prior approval requirements.Knowledge and ability to use established criteria for medical necessity, including Interqual guidelinesKnowledge of notices of non-coverage/denial letters to patients including Medicare/CMRI, federal and state and guidelines.Self motivated, self starter, and able to organize efforts around helping clients have a positive experience.Strong communication skills, particularly verbal and written. Ability to establish and maintain collaborative and effective working relationships. Able to assert needs to patients, families, physicians and other members of the interdisciplinary team while maintaining established rapport and relationshipsAbility to exercises a high degree of initiative, judgment, and discretion.HR Use Only:

KEY REQUIREMENTS:

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