JOB BOARD NURSING JOBS Telephonic Nurse Case Manager

“Nursing solutions built for longevity.”

Location : El Paso, Texas

POSITION SCOPE:
Entry-level position designed to provide training and orientation upon employment as case manager transitions into higher-level position. This CM Level I position encompasses an orientation to the overall scope in providing assistance to the attending physicians in arranging services for prospective, concurrent and retrospective review programs for inpatient and follow up outpatient care.

KEY PERFORMANCE COMPETENCIES:
The Case Manager Level I is responsible for providing onsite or telephonic concurrent review of hospital and skilled nursing facility (SNF) patients under the supervision of a trainer, team leader, or manager. The case manager will be introduced to Milliman USA guidelines and will begin training in the application of clinical pathways to the utilization of hospital and SNF patients. Key training capabilities during this period will be identifying new admissions based on notification or through hospital online portal and being closely monitored by a trainer in accuracy of data entry into HVT according to Milliman guidelines within 24 hours of visit. Hospital rounds training will include discharge planning with patient/family, facility CM, and physician. Will be introduced to resources to ensure utilization of network providers and coverage of services according to health plan benefits and accurate interpretation to customers. During the orientation will attend PCC with higher-level CM to provide understanding of CM responsibilities of supporting clinical review: accurately report information on inpatient cases.

EXPERIENCE:
Five years experience in hospital nursing preferred.
Less than 2 years CM experience.

EDUCATION:
Professional Nursing degree. Must be a licensed RN in the indicated state.

Abe Ghebrehiwet
Senior National Account Executive
Nurse Resolutions
888.411.2228. Toll Free
407.557.2270. Fax

www.nurseresolutions.com
Abe@NurseResolutions.com

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