Follows general technical direction from
nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or…
Current
or future bachelors degree in
nursingor related field. Documents the
nursing care provided which demonstrates the application of the
nursing process…
Experience
or training in insurance benefits
or covered services including Medicare and Medicaid preferred. Acute care utilization review, discharge planning or…
Participates in clinic and
nursing Quality Assurance Programs. Graduate of accredited school of
nursing. Promotes collaboration and professional interaction…
Bachelor's degree in
nursing (BSN/RN)
or Biology. OCCUPATIONAL
HEALTHNURSE, GS-0610-12: Must have 12 months
or more of specialized experiences in performing…
Maintain customer relationships through proactive touches and communicate all relevant product and/or customer concerns
or opportunities to the Management team,…
State
nursing license (LPN/LVN
orRN). Education as required to obtain state
nursing license (LPN/LVN
orRN). Skilled
nursing experience may be required.
Experience Details: Combined experience in utilization management, case management,
homehealth and clinical. Experience with Diamond, Jiva
or InterQual.