Travel Nurse RN - Utilization Review - $35 to $45 per hour in Corpus Christi, TX

Day to Day Responsibilities of this Position and Description of Project:

• Managing a case load for healthcare members with LTSS (Long Term Support/Services) needs.
• In person visits 3-4 days a week in field
• Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver’s license.
• Member assessments and notes.
• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.
• Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact
• Authorize and coordinate referral for services.
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.
• Assist in coordinating the development of informal or voluntary services to integrate into the member care plan
• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services!
• Assist member with filing and resolving complaints and appeals.
• Licensed Clinical Social Worker/Registered Nurse License and 2+ years of physical health care management experience, 4-6+ years of physical health care management experience preferred.
• Hospital CM, Home health, discharge planning, or long-term care experience preferred.