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(RN) Inpatient Nurse Case Manager (California)

Company: Cigna
Location: Visalia
Posted on: December 30, 2018

Job Description:

It's fun to work in a company where people truly BELIEVE in what they are doing! We're committed to bringing passion and customer focus to the business. (RN) Inpatient Nurse Case Manager (California) This is a work at home role in the Glendale or Visalia, CA area. Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. Handles more complex, high acuity cases, and/or account sensitive cases involving largest reserves. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services. May review initial liability disability claims to determine extent and impact of insured's medical condition, medical restrictions and limitationRN with current unrestricted state licensure required. Must reside in CA near Glendale or Visalia office Three to five years clinical practice experience required Utilization management experience required 2 years case management experience strongly preferred May require experience with short or long term disability and knowledge of workers' compensation regulations. Excellent communication and interpersonal skills. Excellent time management, organization and negotiation skills. Strong research and analytical skills. Ability to assess complex issues, recommend changes and resolve problems. Knowledge of managed care preferred. Works independently, receiving direction from manager for new or unprecedented situations. Manages own caseload and coordinates all assigned cases.* Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. . If you require an accommodation based on your physical or mental disability please email: Do not email for an update on your application or to provide your resume as you will not receive a response.

Keywords: Cigna, Visalia , (RN) Inpatient Nurse Case Manager (California), Healthcare , Visalia, California

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