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*Registered Nurse

Integrated Resources, Inc Baton Rouge Contractor
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Job Title: UM Clinical Consultant

RN NURSE not in a clinic/hospital setting.
LOCATION: Working from an office either Baton Rouge or Kenner location.

Job description:
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for appropriate utilization of services.

Fundamental Components/Job Description:
Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management functionGathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care(*) Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)(*) Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment(*) Identifies members who may benefit from care management programs and facilitates referral(*) Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization(*)

Background/Experience desired:
Managed care/utilization review experience preferred3-5 years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. Licensed independent Behavioral Health clinician in state of service or a Registered Nurse (RN) with unrestricted state license.

What other details can you can you share that will help candidates understand what the job is like on a day-to-day basis? Are there additional skills/experience that will help them be successful in this role?
Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Position Summary:

Job Title: UM Clinical Consultant

RN NURSE not in a clinic/hospital setting.
LOCATION: Working from an office either Baton Rouge or Kenner location.

Job description:
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for appropriate utilization of services.

Fundamental Components/Job Description:
Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management functionGathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care(*) Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)(*) Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment(*) Identifies members who may benefit from care management programs and facilitates referral(*) Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization(*)

Background/Experience desired:
Managed care/utilization review experience preferred3-5 years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. Licensed independent Behavioral Health clinician in state of service or a Registered Nurse (RN) with unrestricted state license.

What other details can you can you share that will help candidates understand what the job is like on a day-to-day basis? Are there additional skills/experience that will help them be successful in this role?
Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Duties:

Job Title: UM Clinical Consultant

RN NURSE not in a clinic/hospital setting.
LOCATION: Working from an office either Baton Rouge or Kenner location.

Job description:
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for appropriate utilization of services.

Fundamental Components/Job Description:
Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management functionGathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care(*) Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)(*) Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment(*) Identifies members who may benefit from care management programs and facilitates referral(*) Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization(*)

Background/Experience desired:
Managed care/utilization review experience preferred3-5 years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. Licensed independent Behavioral Health clinician in state of service or a Registered Nurse (RN) with unrestricted state license.

What other details can you can you share that will help candidates understand what the job is like on a day-to-day basis? Are there additional skills/experience that will help them be successful in this role?
Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Experience:

RN NURSE - must be licensed in State

Education:

RN Nurse - must be licensed in State LA
 

Recommended skills

Utilization Management
Hospitals
Managed Care
Behavioral Health
Registered Nurse Certified
Computer Literacy

Location

CareerBuilder Estimated Salary

Based on Job Title, Location and Skills
$65K
Below Avg. Average Above Avg.

Career Path

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*Registered Nurse
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Job ID: 19-18350

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