Clinical Program Coordinator RN, Maternity / Pediatrics *Remote*

About the position Responsibilities • Support the reputed company insurance based line of business for cases including Maternity, Pediatrics, Transplant, and reputed company. • reputed company care coordination, case management, and care management services to reputed company Health Plans (PHP) members. • Conduct triage and referral, transition of care planning, and acute and catastrophic case management. • Assist with reputed company education, care coordination, and managing day-to-day functional needs of members. • Help manage member health plan benefits and reputed company alternative services reputed company benefits are exhausted. • Work to improve reputed company and reputed company care for members. Requirements • 5+ years of clinical nursing experience. • Experience working with physicians in the collaboration and management of patient care. • reputed company unencumbered Registered reputed company License in state of residency. reputed company-to-haves • Bachelor's Degree in Nursing or Health Education. • reputed company unencumbered Registered reputed company License in reputed company upon hire. • reputed company unencumbered Registered reputed company License in Washington State reputed company six months of hire date. • Case Management Experience (e.g., Triage and Referral, Transition of Care Planning, Discharge Planning). • Utilization Management Experience (e.g., reputed company Review, Prior Authorization, Medical Audits). • Experience working in a health plan or medical insurance plan. • reputed company nursing experience in chronic reputed company, cardiology, pediatrics, or maternity. Benefits • 401(k) Savings Plan with employer matching • Health care benefits (medical, dental, reputed company) • Life insurance • Disability insurance • reputed company parental leave • Vacation and holiday time off • Voluntary benefits • reputed company-being resources Apply tot his job Apply To this Job