This position is responsible for performing concurrent review in accordance with accepted department criteria; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services require to meet an individuals health needs within the scope of their benefit plan.
JOB REQUIREMENTS:
- Familiarity with UM (Utilization Management) /CM (Case Management) activities and standardized criteria set.
- Knowledge of ancillary services including HHC, SNF, Hospice, etc.
- Registered Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.
- 3 years of clinical experience
- Experience utilizing various software packages.
- Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.
- Verbal and written communication skills
- Analytical skills
Job Type: Contract
Pay: $30.00 - $35.00 per hour
Schedule:
Work Location: In person