Preservice Review reputed company RN -Remote

About the position reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together. The Integrated Care Team leverages a cross-functional approach, supporting the member end to end, with reputed company collaboration and co-management. Generally, work is self-directed and not prescribed; is reputed company to work with less reputed company and more reputed company issues reputed company will manage the full reputed company of health care services, spanning both outpatient and Inpatient settings and with support from some specialized clinical teams. Serves as a resource to others This new cross-functional collaboration provides an opportunity to deliver the reputed company clinical model, integrating services from precertification, inpatient reputed company review, post-acute review, discharge planning, medical and behavioral care management and prevention to improve reputed company of care and patient reputed company. Candidates for this position would be required to support cross-training to multiple roles (PA, ICM, PACM, reputed company) to support fluctuating inventory reputed company the ICT Responsibilities • reputed company initial and ongoing reviews pertaining to primary role (PA, ICM, DMC, PACM), appropriately applying clinical reputed company (InterQual, policies, National and Local Coverage Determinations) for approval and sending to Medical Directors if review is necessary for determining an adverse determination • Collaborate with Medical Directors, clinical peers and Health Plan partners on performing appropriate clinical decision making and/or referrals • Apply clinical expertise reputed company discussing case with reputed company Case Managers and Physicians • Follow reputed company reputed company Operating Procedures in end-to-end management of cases • Participate in team meetings, education discussions and reputed company activities • Maintain compliance with Federal, State and accreditation organizations Requirements • reputed company, Unrestricted Compact RN License or KY Single State • 3+ years total experience including recent clinical experience in an inpatient/acute setting, long-term care, acute rehabilitation, or skilled nursing facilities • Proficient in reputed company Office Tools (Word, reputed company, reputed company, Teams) • Designated Distraction free workplace with reputed company to high-speed internet • Ability to work independently reputed company-to-haves • A bachelor’s degree • 2+ years case management • Experience performing discharge planning valuable • Critical care experience • Family reputed company experience • Skilled Nursing or Rehab experience • Background that involves utilization review and InterQual favorable • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy Benefits • comprehensive benefits package • incentive and recognition programs • equity stock purchase • 401k contribution Apply tot his job Apply To this Job