Utilization Management Coordinator - (RN) - Abilene, TX
Company: Health Care Service Corporation
Posted on: September 5, 2021
~~ $5000 SIGN ON BONUS ~~
** BONUS applies only to this position Job ID # DLP-1044532
*** Position is Telecommute within 100 miles of
Abilene Headquarters ***
This position is responsible performing initial, concurrent review
activities; discharge care coordination for determining efficiency,
effectiveness and quality of medical/surgical services and serving
as liaison between providers and Medical and Network Management
Divisions. This position reviews service requests, collects
clinical and non-clinical data, verifies eligibility, determines
benefit levels in accordance to contract guidelines, prepares
reports on quality of care, identifies and reports cases, and
provides information regarding utilization management
requirements and operational procedures to members,
providers and facilities. This position will be engaged with
Utilization Management Review.
Registered Nurse (RN) with valid, current, unrestricted license in
The State required.
*3 years of clinical experience in a physician office,
hospital/surgical setting or health care insurance company .
*Knowledge of medical terminology and procedures .
*Verbal and written communication skills.
*Willingness and ability to travel, on a rare occasion, if
PREFERRED JOB REQUIREMENTS:
* 2+ years of
Utilization Management experience is preferred.
* 3 years of clinical experience in various environments including:
acute hospital setting, physician office, LTACH/SNF, home health,
surgical setting or health care insurance company.
* In-patient nursing experience.
* Specialty RN experience - Oncology, NICU, O/R, Cardio, etc. - a
variety of clinical experience is preferred - NOT limited to NICU
or Maternal Health
* Intensive Care and/or Critical Care experience is preferred.
* Case Management, Care Management, Condition Management and/or
Disease Management experience is a plus.
* MCG Certification is a plus.
* Sign on Bonus is only applicable for applicants hired
prior to 12.31.21
Location: TX - Abilene
Activation Date: Wednesday, August 18, 2021
Expiration Date: Saturday, January 1, 2022
Keywords: Health Care Service Corporation, Abilene , Utilization Management Coordinator - (RN) - Abilene, TX, Other , Abilene, Texas
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