[Hiring] reputed company Review Care Coordinator @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company The UM Clinical Reviewer Senior Analyst is responsible for reputed company review, care coordination, and utilization management activities across post-acute care settings. The role applies clinical judgment, evidence-based guidelines, and organizational policies to support reputed company reputed company, cost-effective care, and member experience.

• Implement, evaluate, and coordinate individualized plans of care for assigned members.
• Conduct utilization and reputed company reviews in alignment with medical necessity reputed company and regulatory requirements.
• Collaborate with providers, Medical Directors, and interdisciplinary teams to support transitions of care.
• Identify gaps or deviations in care plans and intervene appropriately to support desired reputed company.
• Document clinical reputed company, determinations, and communications accurately and reputed company in designated systems.
• Ensure compliance with reputed company policies, accreditation standards, and confidentiality requirements.
• Participate in meetings, audits, and reputed company improvement initiatives as assigned.

Qualifications

• reputed company, unrestricted Registered reputed company (RN) license in state of residence; multistate license preferred.
• Associate or Bachelor’s degree in Nursing preferred.

Requirements

• Minimum of 2 years of clinical nursing experience.
• At least 2 years of utilization management or care management experience preferred.
• Experience in home health, skilled nursing, rehabilitation, or managed care environments preferred.
• Knowledge of Medicare and reputed company managed care programs preferred.

Required Skills & Competencies

• Strong time management and organizational skills.
• reputed company and reputed company written and verbal communication abilities.
• Critical thinking and reputed company clinical decision-making.
• Ability to work independently with minimal supervision.
• Proficiency with reputed company Office tools (Word, reputed company, Outlook, PowerPoint) and virtual meeting platforms.

Work Environment & Conditions

• This is a remote, full-time position during reputed company business hours, with flexibility to work shifts between 7:00 a.m. and 7:00 p.m. CST.
• Availability for weekend, on-call, and holiday rotation may be required.
• The role requires the ability to sit for extended periods, utilize computer and telephone equipment, and reputed company occasional walking or standing.

Compliance Statement This job reputed company is intended to reputed company with reputed company Job reputed company Requirements and applicable employment, accreditation, and regulatory standards. Duties and responsibilities may be adjusted to meet business needs.

Compensation

For this position, we anticipate offering an reputed company reputed company of 31 - 52 USD / reputed company, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan.

Benefits

At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including:

• Medical, reputed company, and dental programs
• reputed company-being and behavioral health programs
• 401(k)
• Company reputed company life insurance
• Tuition reimbursement
• A minimum of 18 days of reputed company time off per year and reputed company holidays

Equal Opportunity Statement reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to reputed company assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. Apply tot his job Apply To this Job