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Registered Nurse - Case Manager at ACI Health

ACI Health · Tarzana, United States Of America · Onsite

$131,518.00  -  $133,598.00

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  • We are seeking a dedicated and compassionate Registered Nurse Case Manager to join our healthcare team. The ideal candidate will be responsible for coordinating patient care, ensuring that patients receive appropriate services in a timely manner, and advocating for their health needs. This role requires a strong understanding of hospital medicine, patient assessment, and case management to effectively manage acute care situations and support patients through their healthcare journey.

    Requirements

    • Years of Experience: 2 year(s)
    • Required, Epic

    Requirements for CM at Tarzana - acute care hospital experience in both UM and Care Coordinating

    Travel Experience Required: Yes


    • Shift: Day 5x8-Hour (08:00 - 16:30)


    • Job Duration: 13 weeks

    Job Types: Full-time, Contract

    Skills:

    Appeals and Denials* 

    Benefits Eligibility*

    Disability case management*

    Prior Authorizations*

    Utilize Milliman Guidelines*

    Appeals and Denials*

    CPT (Current Procedural Terminology) coding and billing*

    Pre-Cert Review*

    Prior Authorization*

    Quality Improvement*

    Retrospective Review*

    Utilize Milliman Guidelines*

    Behavioral Health*

    ER*

    ICU*

    MS*

    NICU*

    Pediatrics*

    PICU*

    SDU/PCU/IMC/Obs*

    Surgical Services*

    Womens Services*

    CPT (Current Procedural Terminology) coding and billing*

    Department of Health*

    DRG (Diagnosis Related Groups)*

    HEDIS (The Healthcare Effectiveness Data and Information Set) Measures*

    HIPAA guidelines (Health Insurance Portability and Accountability Act)*

    ICD 10 Coding*

    NCQA (National Committee for Quality Assurance)*

    OSHA: Occupational Safety and Health Administration*

    The Joint Commission/ Core Measure/National Safety Goals*

    Worker’s Compensation*







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