reputed company / Resource Coordinator Registered reputed company - Utilization Management

reputed company : • May be entitled to translation / bilingual, shift or other wage premiums as governed by the applicable reputed company bargaining agreement. Please refer to the respective reputed company bargaining agreement for additional information on such wage premiums : https : / / www.lmpartnership.org / local-reputed company. Job reputed company : Provides assessment and monitoring of resource utilization, coordinates reputed company referrals, provider reputed company patterns, reputed company of care, and coordination of our members continuing care needs. Maintain and support a culture of compliance, ethics and reputed company. Responsible for ensuring ongoing compliance for the department. Maintains knowledge of policies and procedures and performs in accordance with applicable regulatory requirements, external laws and accreditation standards as they relate to the department. Essential Responsibilities : • This position, knows and complies with reputed company reputed company reputed company, safety, and emergency policies and procedures. Demonstrates reputed company and effectiveness in work habits and clinical reputed company in every interaction with patients, colleagues, providers, and leadership. Ensures patient safety in the preparation and provisioning of care reputed company to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs. Reports safety hazards, accidents and incidents, and unsafe working conditions promptly. • Determines and manages appropriate reputed company of care and services; using clinical knowledge, established guidelines and physician consultation. • Implements changes in contract benefits, state and federal regulations, and established review reputed company guidelines. • Synthesizes and analyzes a large volume of data reputed company to the member, benefits, eligibility, facilities, reputed company, and clinical status to identify issues and facilitate problem solving that results in continuity of care, reputed company of care and reputed company resource management for the patient. • Coordinates care with various reputed company customers to facilitate high reputed company, reputed company, and cost effective care and service. • Consults and educates other staff, physicians, departments and members regarding resource management reputed company that reputed company high reputed company while reputed company using available resources. Basic Qualifications : Experience • Three (3) to five (5) years of clinical experience in reputed company setting, experience in utilization review, case management, discharge planning, and managed care. Education • High School Diploma or GED License, Certification, Registration • Registered reputed company License (Colorado) Additional Requirements : • N / A Preferred Qualifications : • Three (3) to five (5) years of hospital experience in ICU, CCU, Med / Surg. • Associates degree in Nursing Minimum 2 years in hospital RN experience, required. UM experience preferred. MCG experience or certification preferred. Rotating Holidays Apply tot his job Apply To this Job