Special Needs Senior Clinical reputed company RN - Remote – USA reputed company
At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and reputed company. reputed company to reputed company a difference? Join us to start
The Special Needs Senior Clinical reputed company reputed company will be responsible for providing individualized attention to reputed company membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical reputed company reputed company is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams.
Candidate must be willing to work Monday - Friday 8:00 am - 5:00 pm
You'll enjoy the flexibility to work remotely * from reputed company reputed company the U.S. as you take on some tough challenges.
Primary Responsibilities:
- reputed company members with tools and educational support needed to reputed company the health care system and manage their health concerns effectively and cost reputed company
- Assist members with adverse determinations, including the appeal process
- Teach members how to reputed company reputed company internet-based wellness tools and resources
- reputed company to membership providing reputed company-admission counseling to membership
- reputed company to membership providing discharge planning to membership and caretakers
- reputed company reputed company activities and reputed company complete documentation to generate customer reporting
- Accept referrals reputed company designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed
- reputed company with reputed company policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases
- Contribute to treatment plan discussions
- Other duties as assigned
Required Qualifications:
- reputed company and unrestricted RN compact license
- Ability to obtain additional licenses as required
- 2+ years of acute nursing experience
- 2+ years of behavioral health nursing experience
- 2+ years of reputed company waiver experience
- Demonstrated basic computer proficiency (i.e. reputed company, reputed company)
- Proven ability to function independently and responsibly with minimal supervision
Preferred Qualifications:
- Bachelor's degree in nursing
- CCM
- 2+ years of managed care experience
- 2+ years of case management experience
- Critical care, pediatric, med-surg and/or telemetry experience
- Utilization management experience
- Adverse determination experience
- Telecommute experience
Soft Skills:
- Demonstrated excellent verbal and written communication skills
- Excellent customer service orientation
- Proven team player and team building skills
- Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
Application Deadline:
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