RN Case Manager

TEKsystems
$52.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, California, Century City
Feb 21, 2025
Description * Develop and maintain working relationships with clinical treatment team members to ensure optimal patient outcomes. * Coordinate with Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, and other departments to ensure positive fiscal management outcomes for patients. * Develop and maintain updated departmental materials and patient education resources. * Conduct regular chart audits to ensure compliance. * Manage payer responsibilities and referral sources. * Oversee negotiations regarding continued stay rationale, length of stays, and the appeals process. * Initiate activities to foster positive business relationships with payers and referral sources to promote repeat business. * Ensure responsiveness to payer systems by maintaining ongoing communication and serving as the primary contact for all external payer sources, thereby generating revenue, enhancing reimbursement, minimizing financial risk, and ensuring payment for the hospital. * Maintain a thorough understanding of insurance coverage and benefits, providing interpretation to patients and families and advocating on their behalf. * Serve as the liaison among all parties involved with the patient. * Participate as part of the interdisciplinary team in developing, implementing, reviewing, and revising the interdisciplinary plan of care. * Manage a caseload of 15-20 cases * Coordinate with other departments to address patient financial responsibilities Additional Skills & Qualifications * Current RN or LCSW license * 1+ years of previous experience in Case Management and Discharge Planning required * CCM Certification Preferred. M-F 8am-5pm Fully On-site Experience Level Intermediate Level Pay and Benefits The pay range for this position is $52.00 - $52.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Century City,CA 90067. Application Deadline This position is anticipated to close on Mar 6, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.