Excellent Utilization and Care Management Clinician position available for you! This position will be a temp to hire role for 3+ months with huge possibility to be extended or even move to a permanent placement! I have provided the job description below.
LOCATIONS: Choice of Portland, OR; Salt Lake City, UT; Lewiston, ID; Burlington, WA.
Telecommuting is also possible provided the candidate has a current RN license and is physically located in Oregon, Idaho, Utah or Washington.
Responsible for both prospective (Sometimes called “precertification review” or “prior authorization”) and concurrent review (Utilization management conducted during a patient's hospital stay or course of treatment, sometimes called “continued stay review”) prior to and during a patient’s admission and treatment in a variety of healthcare settings.
Applies clinical expertise and judgment to ensure compliance with medical policy, medical necessity guidelines, and accepted standards of care.
Utilizes evidence-based criteria that incorporates current and validated clinical research findings.
Consults with physician advisors to ensure clinically appropriate determinations.
Facilitates transitions of care through collaboration with the member, the facilities interdisciplinary team and Case Management programs to achieve optimal recovery for the member.
Responsible for essential activities of case management including assessment, planning, implementation, coordination, monitoring and evaluation.
Active Registered Nurse License
3 years of case management, utilization management or disease management experience
Strong communication and computer skills (including use of Microsoft Office, Outlook, internet search).
Familiarity with health care documentation systems.
Patient focused approach to problem solving, such as looking for opportunities to help each member achieve optimal health outcomes.
Strong organization and time management skills with the ability to manage workload independently.
Qualified and interested candidates are encouraged to apply!
FEEL FREE TO FORWARD THIS OPPORTUNITY TO YOUR FRIENDS/COLLEAGUES!!!
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Job ID: 632241
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