Unknown Company

Utilization Management Nurse RN

Remote • Posted 4 days ago
Remote Contract Human Resources

Overview

Job Title: Nurse Case Management Senior Analyst

Location: REMOTE

Duration: 5-6 Months (Contract possibly Extension)

Schedule: Monday - Friday 8am-5pm (EST or CST); no weekends, evenings, or overtime. 8 hours per day, 40 hours per week.

Base pay range

$45.00/hr - $45.50/hr

Job Profile Summary

  • Nurse Case Management Senior Analyst
  • Delivers specific delegated tasks assigned by a supervisor in the Nurse Case Management job family.
  • Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan.
  • Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members.
  • Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.
  • Provides clinical assessments, health education, and utilization management to members.
  • Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services.
  • Manages own caseload and coordinates all assigned cases.
  • Completes day-to-day Nurse Case Management tasks without immediate supervision, but has ready access to advice from more experienced team members.
  • Tasks involve a degree of forward planning and anticipation of needs/issues.
  • Resolves non-routine issues escalated from more junior team members. RN and current unrestricted nursing license required.

Required Qualifications

  • MCG or Interqual Experience, 2 years of Utilization Management Experience.

EEO

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”

Employment details

  • Seniority level: Mid-Senior level
  • Employment type: Contract
  • Job function: Analyst and Health Care Provider
  • Industries: Hospitals and Health Care

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