Utilization/Case Manager RN - Mountains Community Hospital

Full Time  - Exempt position

SUMMARY

The Case Manager is responsible for utilization management and case management of patient admissions at MCH by collecting and recording all information and data needed for utilization review as requested and required by third party payers.  Monitors and audits medical record charts for presence of documentation to support medical necessity and intensity of services.  Collaborates with physicians for case management and conducts daily Medical Surgical Case Management meetings.  Has a working knowledge of state and federal regulations.

EDUCATION/EXPERIENCE

Current California Registered Nurse License

Five years nursing experience required

CERTIFICATES, LICENSES, REGISTRATIONS

Current license as a Registered Nurse in the State of California