RN Case Manager - Permanent Opportunity with Great Benefits

Company: Yoh Health Care Location: US-CA-San Francisco Status: Full Time, Employee Job Category: Medical/Health Relevant Work Experience: 2+ to 5 Years Career Level: Experienced (Non-Manager)  We've been delivering the best talent to America's leading companies for the past 7 decades - longer than any of our competitors. These customers count on our experience, time-honored processes, responsiveness and market intelligence to build their businesses. Most importantly, they look to Yoh to deliver talent with fresh ideas and empowered minds who want to fulfill their potential. People like you. Life's short. Live your dream. Tell us where you want to work. What you want to do. And we'll help get you there. Yoh Health Care has an opening for an RN Case Manager in San Francisco, California.  This is a permanent, salaried position with excellent benefits!   Responsibilities: • Provides proactive care management services and has responsibility for cases assigned. • Provides specialized medical expertise on complex claims. • Attends field medical appointments and program staffing when indicated and driving to facilities, Injured Employee’s homes, and hospitals. • Determines if recommendations for medical care compares with the company approved best practice standards as well as utilization of nationally recognized guidelines. • Understands URAC standards as they apply to utilization management and applies this understanding in the case/care management process.s • Authorizes services based on company Medical Policy and approved best practice standards including selection of appropriate medical provider from contract provider network for referrals, medical treatment, 2nd opinions, expert medical opinions etc., as well as appropriate utilization of sole source providers and referral to Medical Directors/Advisors for non-certification/dispute resolution. • Proactively applies case management assessment, planning, implementation, coordination and evaluation (APICME) processes to all assigned care managed cases.  Utilizes appropriate designated panel providers as per provider contracts.  • Develops and implements the proactive case management plan based on the medical treatment plan per the treating physician. • Evaluates Injured Employee compliance with care plan and ERTW.  • Provides triage services on cases as designated.  • Assists in contested case preparation/documentation and testimony when requested on company managed claims.    Requirements: • RN Required • BSN, CCM preferred • Must have a minimum of 3 years acute nursing practice and/or experience, or an equivalent combination of education and work experience • Knowledge of MS Office • Related business, case management and utilization management experience is preferredDiscover all that’s possible with Yoh Health Care. Apply now.Yoh is an Equal Opportunity Employer. M/F/H/V. Partnering with Yoh In addition to great career opportunities, consulting with Yoh comes with its perks: Competitive compensation plans Wide variety of benefit options Yoh Advantage - our consultant rewards program that offers discounts and perks at leading companies and with national brands exclusively for Yoh Yoh is one of the largest providers of talent and outsourcing services to customers in the United States. With over 374 million USD in total sales, Yoh operates from more than 75 locations and provides long- and short-term temporary and direct placement of technology and professional personnel, as well as managed staffing services, for the information technology, scientific, engineering, health care and telecommunications communities. For more information, visit yoh.com. Yoh is part of Yoh Services LLC, a Day & Zimmermann Company.