Medix · 2 weeks ago
RN Case Manager
Oxnard, CA, US
Full-time
Onsite
Mid Level
$50/hr - $55/hrMedix is dedicated to providing workforce solutions to clients throughout multiple industries. The Registered Nurse Case Manager plays a critical role in California Children's Services, focusing on medical case review, eligibility determination, and coordination of services for children and young adults with complex medical conditions.
MedicalPharmaceuticalWholesale
Responsibilities
Review and analyze medical records and clinical documentation for pediatric patients with complex diagnoses, including but not limited to cancer, cerebral palsy, and chronic or severe medical conditions
Determine medical eligibility for California Children's Services programs
Process authorizations and denials based on clinical criteria and program guidelines
Conduct thorough medical reviews to ensure compliance with CCS and public health standards
Manage a caseload of approximately 550 cases, completing an average of 10-15 medical reviews per day
Perform the majority of work on the computer, utilizing electronic systems and medical records
Collaborate with healthcare providers, internal teams, and program staff to support continuity of care
Qualification
Required
Active and unrestricted Registered Nurse (RN) license
Experience in case management or pediatric nursing
Experience reviewing medical documentation, authorizations, or utilization management-type work
Benefits
Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)
Health Benefits / Dental / Vision ( Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)
401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)
Short Term Disability Insurance
Term Life Insurance Plan
Company
Medix
At Medix Distribution, we have designed solutions to meet the medical needs for the betterment of society as a whole.
Founded in 2007
11-50 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase