Looking for Case Managers with military background

[hkabik]

Hello,

I represent a nurse staffing and recruiting company. We work for a large Health Plan in California and they are desperately seeking a case manager, preferably with military experience. I have the job posted on veteran's sites, but we cannot seem to find anyone in the location of the job opportunity (Rancho Cordova).

If anyone has connections to nurses in the Sacramento area, here is a description of the job opportunity: The link is also available at: Jobs | PSN Inc

• 
  
• We are seeking an experienced Registered Nurse (RN) with military case management experience to participate in a special program of care planning and coordination of services for health plan members. The Care Coordinator is skillful in transition of care for health plan members throughout the health delivery system and acts as advocate as well as liasion between providers, and members who often are more high risk and high cost. Strong acute utilization review and case management background in managed care is essential.
  The RN will work Monday through Friday during normal business hours for our client, a nationally known managed health care plan in their offices located in southern California. This challenging position requires strong critical thinking skills as well as assessment, coordination, planning and evaluating of multiple environments.
  Job Duties include:
  
  
  • Clinical review of services requiring authorization for appropriateness based on InterQual criteria
    
  • Facilitates the clinical progression of care and collaborates with health plan member, family and members of the military health care team utilization community resources to provide the best quality of care
    
  • Manages and prioritizes care coordination activities applies knowledge of complex care planning
    
  • Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services
    
  • Processes all prior authorizations to completion utilizing appropriate review criteria
    
  • Identifies process improvement opportunities
    
  • Ability to communicate with top level decision-makers to facilitate a safe discharge plan and assure progression of care
    
  
  

  [*]Qualification:

  • Graduate of an accredited program of nursing
    
  • Minimum of five years utilization review/case management or acute care coordination experience in a Managed Care setting
    
  • Exceptional complex care coordination experience required!
    
  • Previous experience working with military a plus!
    
  • Use of InterQual criteria required
    
  • Strong computer skills; proficient in Windows, Excel and prior use of a laptop
    
  • Active unrestricted RN license in CA
    
  
  

  Apply at: Jobs | PSN Inc

  Thank you!!!!!

  [*]