* Minimum 5 years’ experience as a Registered Nurse with demonstrated competence in all aspects of nursing care and independent decision making.
* Minimum two years’ experience in telephone triage.
* Minimum three years’ experience care management or similar area.
* Three years work experience in Microsoft Word, Microsoft Excel and Microsoft Outlook.
* Three years work experience applying evidence-based criteria (i.e.: Milliman, Interqual); Health plan medical policy / clinical coverage guidelines.
* Three years work experience with CMS (Centers for Medicare and Medicaid Services) coverage policies required.
* Able to effectively and clearly communicate (written and verbal) in English.
* Ability to work within approved procedure and clinical guidelines, tools and resources.
* Ability to assess age specific groups from birth to geriatrics.
* Excellent interpersonal communication (one-on-one, and group) and customer service and be able to work both independently and as part of a team.
* Extremely organized self-motivated individual able to handle fluctuating volumes of work, able to prioritize work to meet deadlines. This includes estimation of effort, time management and developing realistic timelines for projects and tasks.
* Ability to independently make and document sound judgments in emergency situations while demonstrating initiative and responsibility.
* Ability to effectively communication with all stakeholders. This includes the ability to professionally and diplomatically debate difficult topics while supporting the Company's position.
* Enhances own professional growth and development through participation in education programs, current literature, in-services, meetings and workshops.
MemorialCare Medical Group is a physician-based organization established to provide advanced comprehensive, effective and efficient health care. With over 30 locations from Long Beach to Dana Point, MemorialCare Medical Group includes more than 250 physicians in the areas of internal medicine, family medicine, pediatrics, geriatric medicine, cardiology, cardio thoracic surgery, gastroenterology, neurology, pulmonology, psychiatry, psychology, rheumatology, sleep medicine and therapeutic acupuncture.
In addition to multiple locations throughout Orange County, MemorialCare Medical Group offers Urgent Care Centers that are open 365 days-a-year, Telephone Advice Nurses available 24 hours-a-day, 7 days-a-week; and lab and digital X-ray services available on-site at most locations.