What are the responsibilities and job description for the Care Review Clinician II position at Careers Integrated Resources Inc?
Job Description:
•** of CA requires two Registered Nurse roles to assist the Plan with discharge planning.
This is a remote role and an exception has been provided for the candidate to reside in CA and be a licensed RN in CA.
temp to hire.
M-F 8:00AM- 5:00 PM PST
These RN s will be working daily with CA hospitals, SNF s, and other lower level of care entities to discharge CA Health Plan members safely to a lower level of care.
Utilization of MCG criteria,
Must Have Skills:
Minimum 5 years of clinical experience as an acute care nurse in med-surg/ tele, ICU or ER setting
Minimum of 2 years (can be part of the 5 years above) as a hospital based discharge planner for patient discharges to home, SNF, custodial care, LTAC and ARU and an in-depth understanding of what services are available in each of these settings
Strong understanding of Medi-Cal post-acute care benefits- what is and is not a benefit
Strong understanding of MCG inpatient criteria
Experience with reviewing and interpreting facility contracts relating to post-acute levels of care (i.e. SNF contract language)
Must demonstrate a high level of accountability to the process of safely, effectively and efficiently transferring members that no longer meet acute care criteria to the most appropriate lower level of care
Must demonstrate a compassionate communication style with members and providers to create seamless transitions in a member s care
Day to Day Responsibilities:
Working with CA hospitals, Skilled Nursing, and other lower level of care settings to discharge Health Plan members safely to a lower level of care.
Required Years of Experience:
Minimum 5 years of clinical experience as an acute care nurse in med surg/tele, ICU or ER setting.
Minimum 3 years discharge experience. Managed care experience.
Required Licensure / Education:
CA licensed RN, Located in CA
•** of CA requires two Registered Nurse roles to assist the Plan with discharge planning.
This is a remote role and an exception has been provided for the candidate to reside in CA and be a licensed RN in CA.
temp to hire.
M-F 8:00AM- 5:00 PM PST
These RN s will be working daily with CA hospitals, SNF s, and other lower level of care entities to discharge CA Health Plan members safely to a lower level of care.
Utilization of MCG criteria,
Must Have Skills:
Minimum 5 years of clinical experience as an acute care nurse in med-surg/ tele, ICU or ER setting
Minimum of 2 years (can be part of the 5 years above) as a hospital based discharge planner for patient discharges to home, SNF, custodial care, LTAC and ARU and an in-depth understanding of what services are available in each of these settings
Strong understanding of Medi-Cal post-acute care benefits- what is and is not a benefit
Strong understanding of MCG inpatient criteria
Experience with reviewing and interpreting facility contracts relating to post-acute levels of care (i.e. SNF contract language)
Must demonstrate a high level of accountability to the process of safely, effectively and efficiently transferring members that no longer meet acute care criteria to the most appropriate lower level of care
Must demonstrate a compassionate communication style with members and providers to create seamless transitions in a member s care
Day to Day Responsibilities:
Working with CA hospitals, Skilled Nursing, and other lower level of care settings to discharge Health Plan members safely to a lower level of care.
Required Years of Experience:
Minimum 5 years of clinical experience as an acute care nurse in med surg/tele, ICU or ER setting.
Minimum 3 years discharge experience. Managed care experience.
Required Licensure / Education:
CA licensed RN, Located in CA
