Pre-Service Care Coordinator - EviCore - Work at Home

The Registered Nurse or Licensed Practical Nurse responsibilities include but not limited to:


* Perform clinical and operational processes related to utilization review of pre-service and retrospective requests for Post-Acute Care services including but not limited to long term acute care, skilled nursing and inpatient rehab facilities.


* Responsible for reviewing the clinical record using evidenced-based guidelines, accurate and timely documentation and communication with health-care providers and Medical Directors for all assigned patients throughout the utilization review process.


* Assist with the coordination between providers and members.

Minimum Education, Licensure and Professional Certification Requirements:


* Current unrestricted Registered Nurse licensure or Licensed Practical Nurse licensure.


* Associate degree or Bachelor Degree in Nursing preferred; completion of LPN program 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 telephonic/Work at Home.


* Hours: Monday - Friday; 9a-6p Central Time Zone; 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, including experience and geographic location.

This role is also antici...