RN Case Managers

Platinum Healthcare is a healthcare staffing company looking for a Registered Nurse or Allied Health Professional for a Contract position as a RN Case Manager in Torrance, CA. The ideal candidate will have a minimum of 2 years of combined case management or clinical experience, knowledge of medical management guidelines, and strong problem-solving skills.

Requirements

• Minimum of 2 years of combined case management or clinical experience
• Working knowledge of InterQual, Meditech, Medicare or other medical management guidelines
• Knowledge of legislative requirements, NCQA guidelines and health plan delegation requirements for utilization management
• Thorough knowledge of health care industry, benefit interpretation, professional/facility reimbursement methodologies, contracts and flow of related information
• Strong problem-solving skills
• Ability to analyze problems and formulate plans, solutions and a course of action
• Ability to multi-task, meet deadlines and maintain department production and quality standards
• Proficient computer skills including Microsoft Excel and Word
• Substantial working knowledge of utilization review/referral processing systems (i.e. EZ Cap, Diamond, IDX)
• Excellent interpersonal, verbal and written communication skills