Benefits available to full-time employees after 90 days of employment
401(k) with company match available for full-time employees after 1 year of service on eligibility dates
Highlights
Contract assignment with potential for permanent hire based on attendance, performance, and business needs
Position requires availability from 8:00 AM to 4:00 PM, Monday to Friday
Responsibilities
Review and evaluate clinical information and documentation.
Interpret data from clinical records or systems to apply appropriate clinical criteria and policies, aligning with regulatory and accreditation requirements for member and provider issues.
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, manage costs effectively, and improve program efficiency.
Independently coordinate clinical resolutions with internal and external clinician support as needed.
Evaluate potential Quality of Care issues based on clinical policies and benefit determinations.
Consider all documented system information and additional records/data to develop determinations or recommendations.
Requirements
BSN required
Utilization management and quality screenings experience required; In-Patient Case Management experience is essential.
2 years of acute care experience strongly preferred, with Case Management and Managed Care experience required.
If you believe this Nurse Case Manager position aligns with your skills and career goals, please don't hesitate to contact us. Feel free to call, email, or apply through this posting!
Employment Type: Full-Time
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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