Job Description
Requirements:
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- Active California RN License (Required)
- ADN or higher in Nursing
- 3+ years of RN experience
- Experience in Case Management, Utilization Review, Discharge Planning, or Managed Care preferred
- Strong clinical assessment and documentation skills
- Authorization Review experience is a plus
- Bilingual candidates (Spanish, Vietnamese, Chinese, Korean, Arabic, Russian, or Farsi) preferred
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Responsibilities:
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- Review medical authorization requests
- Perform clinical assessments
- Coordinate with physicians, caregivers, and providers
- Document case reviews and authorization decisions
- Ensure services meet Medi-Cal guidelines
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