Utilization Management Registered Nurse - Home Health
Core
Utilization Management Nurse supporting coordination, documentation, and communication of medical services and benefit administration determinations for home health members.
Role type
Utilization Management Registered Nurse
Builds
Coordinated care plans and benefit determinations for home health members
Domain
Healthcare / Insurance / Home Health
Required skills
Clinical nursing skills, Geriatric patient care experience, Telephonic communication, Microsoft Office (Word, Outlook, Excel), Independent decision making, Analytical skills
Preferred skills
Home health experience, Utilization management experience, Managed care setting experience, Health Plan experience, CGX experience
Technologies
Microsoft Word, Microsoft Outlook, Microsoft Excel
Responsibilities
Interpret clinical information to make recommendations for patient outcomes, Navigate multiple systems while working cases, Collaborate with internal and external parties, Ensure fully coordinated care at home, Follow established guidelines and processes
Seniority
Mid-level, hands-on IC