Outpatient Referrals Case Manager, RN
Health Care Services
Ideal candidate will: • Conduct internal audits of inpatient and outpatient referrals. • Oversee internal monitoring activities conducted by others to determine that core department activities are in compliance with established control systems, policies, procedures, standards, and requirements. • Prepare and provide analysis and reports of audits to designated departments and work with team to implement and monitor corrective action. Preferred attributes of ideal candidate: • Previous experience in managed care. • Experience in Quality Management, Utilization Management preferred. • BSN with unencumbered CA RN license. • May consider Licensed Vocational Nurse with strong clinical skills. • Advanced knowledge of Microsoft Word, Excel, PowerPoint and Outlook. • Excellent verbal and written communication skills, with the ability to clearly articulate thoughts and ideas. • Organizational skills with the ability to handle multiple tasks and/or projects at one time. • Customer service skills with the ability to interact professionally and effectively with providers, physicians, and staff from all departments within and outside the Company. • Decision-making skills with the ability to investigate and weigh alternatives and select the course of action that provides the greatest benefit to the organization. • Bilingual (English/Spanish) preferred.