Rady Children's Hospital San Diego RN UM/Case Management/Capitation Nurse-50271 in San Diego, California

This is a Casual with an anticipated assignment length through January 31, 2019 and subject to renewal thereafter.

JOB SUMMARY:

Under the supervision of the UM/QI Supervisor and/or Manager and Compliance Liaison, the Utilization/Case Manager Nurse coordinates the delivery of care through assessment, planning, facilitation, and patient advocacy to ensure cost-effective, quality outcomes of care. The Utilization/Case Manager Nurse works with all members of the health care team to ensure optimal outcomes are reached while appropriate utilization occurs.

MINIMUM QUALIFICATIONS:

Associate's Degree or Nursing Diploma

Current California Registered Nursing Licensure

Three years of experience

Managed Care experience (will consider Hospital Case Management Experience)

Knowledge of common medical insurance operations

Strong mathematical and reasoning skills

PREFERRED QUALIFICATIONS:

Bachelor's Degree

Case Management Certification Experience

Pediatric Nursing Experience

Professional nursing certification