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HC - Utilization Review Nurse - Senior

The Judge Group Mendota Contractor
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!  Judge Healthcare is currently seeking several Call Center RN’s in Greensboro NC and St. Louis MO

Position Summary:

Call Center Registered Nurse- The role is to provide care 24/7 for health and well-being service where members are connected to clinical, wellness, through our phone lines by speaking with a registered nurse.

Expectation is for each nurse to have experience in nursing and to help drive better health outcomes. Call Center nurses are required to be a registered nurses who will provide guidance to members to help them find the Right Treatment, Right Provider, Right Medication and Right Lifestyle, the role also includes:

Answering questions about an illness or injury

Providing support on managing a chronic condition or assessing treatment options

Identifying Premium providers and even scheduling appointments

Coaching on medication adherence, drug interactions or medication alternatives

Preventive care information and healthy lifestyle coaching

Registered nurses use a clinically sound approach through evidence-based clinical guidelines when interacting with members. Nurses have access to a whole-person view of the members health history, at the time of the call allowing them to address not only the immediate symptom, but a members total health status. Integration with other programs helps drive higher referral rates across the continuum of care, including disease management, case management and wellness. Members are connected to health resources they need on a timely basis to deliver results to:

Avoid Emergency Room (ER) visits for callers when it is not necessary to seek care in an ER.

Enroll members into eligible Clinical programs to improve overall health

Increase Member Satisfaction and provide positive Experience to all callers

Other duties as assigned. Qualifications include: Active RN encumbered nurse licensure; minimum of 3 year clinical experience in an acute care setting experience preferred, Sound clinical judgment, Demonstrated understanding of managed care concepts, Strong problem solving and decision making skills, Strong departmental team player, Good written and verbal communication skills, Personal computer skills include Microsoft, word, excel and PowerPoint.

The positions will be located in Greensboro NC and St Louis MO and the RN must be licensed in the state they reside NC or MO.

Training hours are 8 to 5 M-F

Dress Code: Business Casual

Please send your MOST UP TO DATE resume to Robert at URL blocked - click to apply or give Robert a call at (Phone number blocked - click to apply) or TXT Phone number blocked - click to apply.


Recommended skills

Verbal Communication
Microsoft Access
Decision Making
Computer Literacy
Microsoft Excel
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Job ID: 635305


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