The role utilizes clinical expertise to collaborate with residents, families, and providers to develop care plans that balance extraordinary care with cost sensitivity
Job Summary
The role utilizes clinical expertise to collaborate with residents, families, and providers to develop care plans that balance extraordinary care with cost sensitivity.
Essential responsibilities include monitoring resident status changes, coordinating admissions and discharges, and performing utilization reviews to ensure timely and appropriate care.
Candidates must possess strong communication skills to effectively interact with physicians, payers, and families while maintaining accurate documentation in a high-volume environment.
Matching Summary
The role utilizes clinical expertise to collaborate with residents, families, and providers to develop care plans that balance extraordinary care with cost sensitivity.
Skills & Requirements
Must-have
Bachelor's Degree in Nursing or Social Work
Registered Nurse license preferred
Medicare Medi-cal Medicaid knowledge
Clinical nursing experience preferred
Utilization review activities
Care plan development and implementation
Nice-to-have
Certified Case Manager (CCM) certificate
PCC Knowledge preferred
Excellent time management skills
Intermediate computer skills
Sound judgement in interactions
Ability to work independently
Key Requirements
Bachelor's Degree in Nursing or Social Work
RN license preferred; LVN/LPN acceptable
Two years of clinical nursing experience preferred
Knowledge of Medicare, Medi-cal, and Medicaid programs
Maintain good standing with Department of Public Health