Tracking Code
- 14720
- Job Description
- Responsible for review and management of assigned cases for utilization review and system reimbursement. Participates in the coordination and completion of regulatory audits. Utilizes critical thinking, interpersonal and technical skills in data collection and denial management.Basic Qualifications: Current California RN license.Minimum Qualifications: Three to five years recent clinical experience in a variety of settings. Previous UM, Discharge Planning, or Case Management experience is preferred. Knowledge of InterQual and Milliman criteria. Understanding of financial reimbursements, state and federal insurance programs, and the revenue cycle is strongly recommended. Ability to manage multiple tasks within regulatory agency time frames required. Strong computer skills including spreadsheet and data base management.Preferred Qualifications: BSN preferred. Certification in UR/UM or CM preferred.
- Required Skills
- NOTE: While you may be offered a position at a specific Scripps location, based on business needs and as part of the One Scripps vision, you understand that you may be required to work in a similar department at sites across the system.
- Job Location
- San Diego, California, United States
- Position Type
- Co-op
Department
Case Management
Job Type
Casual/Per Diem
Shift Type
Days
Shift Hours
8 Hour Shift
Days Worked
Varied
Division
Administrative Services
0 comments:
Post a Comment