Concurrent Review Care Coordinator - EviCore - Work at Home
The Registered Nurse will perform clinical and operational processes related to transition/coordination of care and utilization/case management of Post-Acute Care services including but not limited to long-term acute care, skilled nursing and inpatient rehab facilities, home health care, care management, and utilization review.
The Registered Nurse is responsible for the implementation, evaluation, and coordination of the plan of care for all assigned patients.
Develops care plans and other case management tools by participating in meetings.
Identifies progress toward desired care outcomes; intervenes to overcome deviations in the expected plan of care; reviews the care plan with patients in conjunction with direct care providers.
Monitors delivery and utilization of care by completing patient rounds with Medical Directors.
Minimum Education, Licensure and Professional Certification Requirements:
* Current unrestricted Registered Nurse licensure.
* Associate degree or Bachelor Degree in Nursing preferred
* Multistate license preferred
Minimum Experience Required:
* 2+ years of clinical experience
* 2 + years experience in utilization management preferred.
* Home health, SNF, and/or rehab experience desired
* Medicare/Medicaid managed care programs preferred
* Position is remote
* Hours: Monday - Friday; 8a-5p Central; Position is full-time during core business hours with the ability to work any shift between 7 am and 7 pm CST.
* Availability for weekend rotation, on-call rotation, and holiday rotation.
* Ability to sit at a desk 50% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standing.
* Ability to perform dependable and reliable work schedule is essential ••
Required Skills:
* Time-management : Ability to effectively manage one's time and resources to ensure that work is completed efficiently Excellent organizational skills
* Communication : Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership
* Critical-Thinking/Decision-making : Ability to choose a course of action or develop appropriate solutions by identifying and understanding issues, problems, and opportunities
* Autonomy : Ability to work independently with little to no supervision
* Proficient in computer literacy skills with the ability to use and troubleshoot Microsoft Word, Excel, Outlook, and PowerPoint with the ability to type 30 wpm preferred
* Experience using videoconferencing systems such as WebEx
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 27 - 41 USD / hourly, depending on relevant factors, in...
- Rate: Not Specified
- Location: Franklin, US-TN
- Type: Permanent
- Industry: Finance
- Recruiter: Cigna
- Contact: Recruiter Name
- Email: to view click here
- Reference: 24015824
- Posted: 2024-11-21 08:39:11 -
- View all Jobs from Cigna
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