UM Review Nurse (RN)
at RCM Health Care Services

Date Posted: 2/28/2019

Job Description

Case Management Nurse
Company Info:
  • IPA with strong commitment to helping its members stay healthy
  • Position will be Mon-Fri, business hours
Job Description:
  • Telephonic case management of members with high risk and chronic conditions. 
  • Assess, plan, implement, coordinate, monitor, and evaluate options and services to meet members health needs
  • Locate services and programs patient may be eligible for
  • Monitor patients with chronic diseases, recommend and assist with healthier lifestyle choices and other available resources to promote quality cost-effective outcomes.  
  • Act as a healthcare resource in order to help ensure members’ needs are being met.
  • Personalize assistance to members’ individual needs.
  • Provide valuable information and support to allow patient to make informed decisions.
  • Coordinate patient care with PCP, specialists, hospitals, health plans, interdisciplinary care team and patient's family.
  • Review medical records, authorizations and care plans.
  • May occasional conduct in-home assessments when appropriate.
  • Monitored changes in patient's health status.
  • Educated members regarding diagnosis and treatment plan
  • Current unrestricted CA RN, CMC or CCM desirable
  • 2+ years of experience performing care coordination, utilization review, discharge planning and case management
  • Experience in a Managed Care or Home Health setting preferred
  • Good communication skills, and ability to read and understand health plan contracts
  • Competitive pay ($35-$45/hour depending on experience)
  • Full Medical Benefits package including PPO/HMO, 403A and 403B retirement, life insurance, etc
  • Paid Time Off

Job Snapshot

About Us

RCM Health Care Services offers career defining opportunities to candidates from the leading employers in health care. Whether you’re looking for a new job or seeking to hire the best medical talent, RCM Health Care Services has the solution for you. Since 1975, we’ve established ourselves as a leader in the recruitment industry by connecting thousands of healthcare professionals with placements that support their needs. If you’re looking to make the next move in your career, let RCM be your guide, we’re with you every step of the way!

We proudly hold the Joint Commission Gold Seal of Approval.

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