Jobs, career information, and employment services for job candidates, employees, employers and recruiters.
Nurse, Utilization Management (Evenings
- Work at Home Jobs, Work from Home Jobs
Applicant Category: Professional
Requisition Code: Work at Home
Two Initials of Recruiter: WH
System Date: 10/30/2006
System Time: 09:24:30
Document Name(40): Nurse, Utilization Management (Evenings
Source: BaltimoreSun.com
SearchTerms: "work at home" "work from home"
URL(80): http://www.careerbuilder.com/JobSeeker/Jobs/JobDetails.aspx?lr=cbcb_bs&IPath=JRK
Nurse, Utilization Management (Evenings and Weekends) .
Save this Job | Email this job | Printer-Friendly Version .
Company: HealthCare Strategies, Inc. .
Location: US-MD-Columbia .
Base Pay: $16.00 - $19.00 /Hour .
Bonus: $1,000.00 .
Employee Type: Full-Time Employee .
Industry: Healthcare - Health Services
Insurance
Managed Care .
Manages Others: no .
Job Type: Health Care
Management
Nurse .
Req'd Education: 2 Year Degree .
Req'd Experience: At Least 3 Years .
Req'd Travel: None .
Relocation Covered: No .
Posted Date : 10/26/2006 .
Contact: Henry DeTitta Phone: Not Available .
Email: Send Email Now Fax: 410-423-9430
Instantly fax your resume! >> .
Ref ID: AH-RN (FT) .
DESCRIPTION .
Do you want to work from the comfort of your own HOME? Do you want to work for a progressive company that is a leader in their industry? Here is what we are looking for: A hard working, progressive RN with leadership qualities that is available to work evenings and/or weekends. Hours that we are looking to cover are 7:00PM to 8:00AM Mondays through Fridays and 8:00AM Saturdays to Mondays at 8:00AM. There are currently multiple openings!
Summary of Job:
Responsible for the collection of personal and clinical information on participating Plan members for the purposes of:
* Providing patient education services.
* Rendering initial determinations of medical appropriateness for communication to the health benefit plan.
*Identifying individuals whose health and/or expenses may be positively affected through application of Large Case Management.
Specifics:
* Perform Clinical Assessments
* Obtain appropriate information from health care provider and or patient or family regarding planned procedure, admission, continued stay or discharge plan.
* Interpret nationally recognized criteria to support recommendations for inpatient and outpatient services.
* Identify and refer individuals whose health and/or expenses may be positively affected through the application of Large Case Management.
* Document each call completely, accurately and promptly into the computer system.
* Follow documented policies and procedures for the handling of confidential materials and/or patient specific information.
* Answer direct telephone calls related to medical services in order to determine if prior authorization is required for the requested services.
* Retrieve and acknowledge messages requesting medical services from voicemail.
* Complete all medical necessity reviews and communicate outcomes to providers within the appropriate time frames.
* Provide educational materials and direct callers to community services when indicated.
* Answer calls for the HealthCare Strategies Medical Information Help Line
Other Duties -
* Provide coverage for professional colleagues. .
REQUIREMENTS .
QUALIFICATION REQUIREMENTS:
Required:
* Active, unrestricted RN License
* 3+ years experience in hospital setting
* Must live within 35 miles of our office to qualify to work from home.
Abilities/Skills:
* Strong verbal and written communication skills.
* Problem-solving and decision-making skills.
* Ability to carry out detailed written or verbal instruction independently.
* Basic mathematical skills.
* Basic computer skills.
* Familiarity with general office equipment.
Email This Page!