Inpatient Review Nurse (Remote | California RN/LVN License Required | Pacific Time Schedule)

Alignment Health
California, United States
Full Time
Remote
Mid
USD 77,905 – 116,858
Professional Certificate
Healthcare Healthcare Life Sciences

Posted 1 week ago

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Excellent 4.7

Job summary

Remote inpatient review nurse managing patient care assessments, utilization, and coordination for seniors, utilizing clinical guidelines, and collaborating with healthcare team members. Requires California RN or LVN license, with experience in case management, inpatient review, and Medicare plans.

Responsibilities

The inpatient review nurse assists patients through the continuum of care by collaborating with physicians and facility staff to ensure appropriate, cost-effective medical services. They perform inpatient reviews, manage referrals, and coordinate care activities while maintaining safety and quality standards.

Qualifications

case management communication complex/catastrophic case management critical thinking inpatient review mathematical skills Medicare Managed Care Plans Milliman Care Guidelines problem-solving report analysis

Candidates must hold an active, valid, and unrestricted California RN or LVN license and possess at least three years of general case management experience. Additionally, a minimum of two years of experience utilizing Milliman Care Guidelines in a managed care setting is required.

English

Company

Alignment Health

Alignment Health

linkedin
Hospitals and Health Care
Location
California, United States

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Excellent 4.7
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