This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services required to meet an individuals health needs within the scope of their benefit plan.
* Registered Nurse (RN) with current, valid, unrestricted license to practice in state of operations.
* 3 years clinical practice experience.
* Experience utilizing various software packages.
* Verbal and written communication skills.
* Analytical skills.
* Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.
PREFERRED JOB REQUIREMENTS:
* Familiarity with UM/CM activities and standardized criteria set.
* UM experience.
* Knowledge of ancillary services including HHC, SNF, Hospice, etc.
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Expertise Other, Nursing, Behavioral Health Job Type Full-Time Regular Location OK – Tulsa, OK – Oklahoma CityPandoLogic. Category: Healthcare, Keywords: Utilization Review Coordinator
Tagged as: management