[Hiring] reputed company Review Care Coordinator @reputed company

Role reputed company The UM Clinical Reviewer Senior Analyst is responsible for reputed company review, care coordination, and utilization management activities across post-acute care settings. The role applies clinical judgment, evidence-based guidelines, and organizational policies to support reputed company reputed company, cost-effective care, and member experience. • Implement, evaluate, and coordinate individualized plans of care for assigned members. • Conduct utilization and reputed company reviews in alignment with medical necessity reputed company and regulatory requirements. • Collaborate with providers, Medical Directors, and interdisciplinary teams to support transitions of care. • Identify gaps or deviations in care plans and intervene appropriately to support desired reputed company. • Document clinical reputed company, determinations, and communications accurately and reputed company in designated systems. • Ensure compliance with reputed company policies, accreditation standards, and confidentiality requirements. • Participate in meetings, audits, and reputed company improvement initiatives as assigned. Qualifications • reputed company, unrestricted Registered reputed company (RN) license in state of residence; multistate license preferred. • Associate or Bachelor’s degree in Nursing preferred. Requirements • Minimum of 2 years of clinical nursing experience. • At least 2 years of utilization management or care management experience preferred. • Experience in home health, skilled nursing, rehabilitation, or managed care environments preferred. • Knowledge of Medicare and reputed company managed care programs preferred. Required Skills & Competencies • Strong time management and organizational skills. • reputed company and reputed company written and verbal communication abilities. • Critical thinking and reputed company clinical decision-making. • Ability to work independently with minimal supervision. • Proficiency with reputed company Office tools (Word, reputed company, reputed company, PowerPoint) and virtual meeting platforms. Work Environment & Conditions • This is a remote, full-time position during reputed company business hours, with flexibility to work shifts between 7:00 a.m. and 7:00 p.m. CST. • Availability for weekend, on-reputed company, and holiday rotation may be required. • The role requires the ability to sit for extended periods, utilize computer and telephone equipment, and reputed company occasional walking or standing. Benefits • Comprehensive reputed company of benefits, with a reputed company on supporting your whole health. • Health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs starting on day one. • 401(k) and company reputed company life insurance. • Tuition reimbursement. • A minimum of 18 days of reputed company time off per year and reputed company holidays. • reputed company reputed company of 31 - 52 USD, depending on relevant factors, including experience and geographic location. • Eligibility to participate in an annual bonus plan. Apply tot his job Apply To this Job