CENTRAL CALIFORNIA ALLIANCE FOR HEALTH Concurrent Review Nurse I (RN), Part-time Salary in the United States

We have an opening for a part-time Concurrent Review Nurse (RN) in either our Salinas or Scotts Valley office. This position will work 40 hours per two-week pay period. 

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Utilization Management- Concurrent Review Supervisor, you will perform concurrent or post-service (retrospective) review of acute in-patient care services using established criteria; Participate in the Utilization Management (UM) Care Programs. 

ABOUT THE TEAM

We review member care and services to validate the necessity and to explore alternatives to inpatient care. We also track the consumption of resources and the progress of members while being treated.

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

• Knowledge of:
  • Utilization Management, and/or Case Management principles and practices
  • Medi-Cal and related policies and Title 22 regulations
• Ability to:
  
  • Demonstrate strong critical thinking and problem solving skills
  • Use MS Office Software Suite
  • Use a laptop for medical documentation and chart review
  • Navigate and evaluate electronic medical records and other health care data in order to determine the appropriate level of care
  • Give clear direction and sequence information verbally, so others can follow and understand
• Education and Experience:
  • • Associate’s degree in Nursing
    • Current unrestricted license as a Registered Nurse issued by the State of California
    • A minimum of three years (or a Bachelor’s degree and one year) of experience in an acute care setting, which included some experience in Utilization Management, Case Management or similar health programs; or an equivalent combination of education and relevant work experience may be qualifying

Certain benefits are available on a prorated basis for part-time employees working less than 30 hours/week. These include, but are not limited to, PTO, holidays and 401(a) retirement plan.