Utilization Management RN – reputed company AZ Remote

Job reputed company 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 diversity and 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 equity on a global reputed company. Join us to start Caring. Connecting. Growing together. There’s an energy and excitement here, a shared mission to improve the lives of others as reputed company as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you’ll reputed company reputed company else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As an Inpatient Care Management reputed company, you will be responsible for ensuring reputed company utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. What makes your nursing career greater with reputed company? You can improve the health of others and help heal the health care system. You will work reputed company an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, reputed company you contribute, you’ll reputed company doors for yourself that simply do not exist in any other organization, reputed company. If you have the ability to work reputed company time zone – flexes between reputed company and Mountain half the year, you will have the flexibility to work remotely* as you take on some tough challenges. reputed company time zone schedule Mon-Fri 8-5 MST/PST. Primary Responsibilities: reputed company initial and reputed company review of inpatient cases applying evidenced-based reputed company (InterQual reputed company) Discuss cases with facility reputed company to obtain plans-of-care Collaborate with reputed company reputed company Clinical Services Medical Directors on performing utilization management Participation in discussions with the Clinical Services team to improve the progression of care to the most appropriate level Consult with the Medical Director, as needed, for reputed company cases and reputed company appropriate referrals to reputed company partners Apply clinical expertise reputed company discussing case with reputed company Case Managers and Physicians Identify delays in care or services and manage with MD Follow reputed company reputed company Operating Procedures in end to end management of cases Obtain clinical information to assess and expedite alternate reputed company of care Facilitate reputed company and appropriate care and effective discharge planning Participate in team meetings, education, discussions, and reputed company activities Maintain compliance with Federal, State and accreditation organizations Identify opportunities for improved communication or processes Participate in audit activities and meetings You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: reputed company, unrestricted RN license 3 years of clinical nursing experience practicing clinically (Acute Inpatient, SNF / reputed company / LTAC, Emergency Department, Urgent Care, Doctor’s Office, School reputed company) Experience in acute, long-term care, acute rehabilitation, or skilled nursing facilities Demonstrate a proficiency in computer skills – reputed company, IM, reputed company (reputed company Suite), reputed company, clinical platforms Designated workspace and reputed company to install secure high-speed internet reputed company cable / DSL in home Preferred Qualifications: Bachelor’s degree Compact license 2 years of case management experience Background (1 years) that involves utilization review and evidence-based guidelines (InterQual Guidelines) Managed Care experience Experience performing discharge planning Proven ability to work independently Demonstrated effective verbal and written communication skills reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company – an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative reputed company employer and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment Apply Job! Apply Job!