Looking for Registered Nurses (RN) who will develop, implement, and evaluate individualized patient care plans. Nurses will act as social workers, advocate patient welfare, and serve as a liaison between patients, their families, and healthcare providers.
- Determines, develops and implements a plan of care based on accurate and comprehensive assessment of the member's needs.
- Applies detailed knowledge of FEP PPO and company's established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case.
- Works with complex cases, promotes the delivery of quality; cost-effective health care services based on medical necessity and contractual benefits.
- Provides guidance to the provider network.
- Performs effective discharge planning and collaborates with member support system and health care professionals involved in the continuum of care.
- Coordinates Care for Lower Level of Care coordination such as Skilled Nursing Facility, Home Health, Home Infusion, Rehab.
- Makes referrals to Quality Management, Catastrophic Case Management and Appeals and Grievance Department.
- Bachelor' s of Science in Nursing or advanced degree preferred.
- Active California RN license required.
- Must have 2 years specialty training in one of the following specialized areas: oncology, palliative care, or hospice
- 7 years experience in case management, utilization management, post service review, quality management or health plan/IPA management.
- Case Management Certification preferred
- Comprehensive knowledge of case management, discharge planning, utilization management and community resources
We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.