Job Description
413221 -
Location: Richardson, TX
Education Required: Not Indicated
Experience Required: At least 2 years
Position Description:
BASIC FUNCTION:
This position is responsible for performing concurrent review in accordance with accepted department criteria; performing discharge planning and identifying alternate treatment programs for chronic or catastrophic cases to provide medically necessary, cost effective services; consulting with physicians, providers, members, and other resources, as appropriate, to assess, plan, facilitate implementation, coordinate, monitor and evaluate options and services required to meet an individuals health needs, using communication and available resources to promote quality, cost effective outcomes; performing special departmental projects; and serving as preceptor for less experienced staff.
JOB REQUIREMENTS:
1) Registered Nurse (RN) currently licensed in state; 2) 3 years clinical practice experience; 3) 3 years experience in health insurance/managed care; 4) Case Management certification; 5) PC and database experience; 6) Verbal and written communication skills.
PREFERRED JOB REQUIREMENTS:
1) Experience in disease management; 2) Knowledge of medical management polices and procedures.
Job Requirements
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