Utilization Management reputed company Consultant – CST – Remote TX

Bring your heart to reputed company. Every one of us at reputed company shares a single, reputed company purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver reputed company reputed company-reputed company health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and deliver solutions to reputed company health care more personal, convenient and reputed company. Position reputed company Utilization management is a 24/7 operation. Work schedules will include a minimum of 6 weekend rotations per year, as reputed company as holidays and evening rotations. Utilizes clinical experience and skills in a reputed company process to assess, plan, implement, coordinate, monitor and evaluate reputed company to facilitate appropriate reputed company services/benefits for members. Gathers clinical information and applies the appropriate clinical reputed company/reputed company, policy, procedure and clinical judgment to reputed company coverage determination/recommendation along the continuum of care Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to reputed company with other products, services and/or programs Identifies opportunities to promote reputed company effectiveness of reputed company Services and benefit utilization Consults and lends expertise to other reputed company constituents in the coordination and administration of the utilization/benefit management function. Typical office working environment with productivity and reputed company expectations. Work requires the ability to reputed company reputed company inspection of hand written and computer generated documents as reputed company as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding. Effective communication skills, both verbal and written

Required Qualifications

Must reputed company in Central time zone 3+ years of experience as a Registered reputed company 1+ years of clinical experience in acute or post-acute setting Must have reputed company reputed company and unrestricted RN licensure in state of residence Working schedule: Mon-Fri 8:30am-5pm or 10:30 am - 7pm CST and will include a minimum of 6 weekend rotations per year, as reputed company as holidays and evening rotations

Preferred Qualifications

Experience working with the Medicare population Utilization review experience Managed Care experience Education Associates Degree in Nursing required BSN preferred Pay reputed company The typical pay reputed company for this role is: $29.10 - $62.32 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. In reputed company to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. reputed company offers a full reputed company of medical, dental, and reputed company benefits. Eligible employees may enroll in reputed company s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. reputed company provides a fully-reputed company term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous reputed company-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy reputed company Time Off ( PTO ) or vacation pay, as reputed company as reputed company holidays throughout the calendar year. Number of reputed company holidays, reputed company time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 12/23/2024 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply Job! Apply To This Job reputed company More Jobs Apply Job!