Onsite Telephonic Nurse Case Manager / Utilization Review (RN) - San Diego CA

GENEX Services, Inc. (www.genexservices.com) is the premier provider of cost-containment and fully integrated care management services in the occupational, auto and group healthcare markets. Our 2,200 medical and business professionals provide comprehensive care solutions to more than 1,200 clients from 120 locations throughout the United States, Puerto Rico and Canada.

 

We are currently seeking a Telephonic Nurse Case Manager and Utilization Review (RN) to work onsite at our client location in Roseville, Oakland and San Diego CA.

 

RESPONSIBILITIES: Working on-site with insurance adjusters to provide Utilization Review and Case Management Services.  Responsible for assessment, planning, coordination, implementation and evaluation of injured/disabled individuals involved in the medical case management process.  Works as an intermediary between carriers, attorneys, medical care providers, employers and employees to ensure appropriate and cost-effective healthcare services and a medically rehabilitated individual who is ready to return to an optimal level of work and functioning.  Responsible for the performance of Utilization Review services, including pre-admission certification, second surgical opinion, concurrent utilization review, and Evidenced Based medicine validation. Provision of comprehensive California Utilization Review, incorporating the strategies of cost containment and appropriate utilization of services, which helps address the issues of access to quality healthcare services at an affordable cost. 

 

REQUIREMENTS: Diploma, Associates Degree or Bachelor’s Degree in Nursing required. Registered nurse with current, valid CA state licensure is required. Computer literacy is required. Other state licenses/certifications as required by law. 2+ years prior Case Management experience preferred. Excellent interpersonal skills, phone manners and organizational skills are necessary. The ability to set priorities and work independently is essential. Computer literacy is also required. Spanish speaking ability a plus!  Please include your salary range when applying to this position.

 

GENEX offers a comprehensive compensation and benefits program including a competitive salary and incentive program, medical, dental, life and LTD insurance, 401 (k) with company match and 100% vesting after 90 days of employment, flexible work schedule and a Continuing Education Program accredited by CCM, CRC and CDMS.

 

Please apply using the URL link below or click on ‘Apply Online’. You can also send your resume to hr@genexservices.com or fax to 877-463-3838. Please reference Job:3323 when applying. The final date to apply is June 2008. EOE M/F/D/V

 

http://jobs-genexservices.icims.com/genexservices_jobs/jobs/candidate/job.jsp?jobid=3323&mode=view