Care Coordinator-Home Health (Saint Albans) - MedSolutions Inc. dba eviCore healthcare (Saint
The Registered Nurse will perform clinical and operational processes related to transition / coordination of care and utilization / case management of Post-Acute Care services including but not limited to long term acute care, skilled nursing and inpatient rehab facilities, home health care, care management, and utilization review. The Registered Nurse is responsible for the implementation, evaluation and coordination of the plan of care for all assigned patients. Develops care plan and other case management tools by coordinating/consulting with Home Health Agencies as well as member. Identifies progress toward desired care outcomes; intervening to overcome deviations in the expected plan of care; reviewing the care plan with members in conjunction with the direct care providers. Monitors delivery and utilization of care by completing member rounds with Medical Directors.
Current unrestricted Registered Nurse licensure without restrictionsMinimum 5 years clinical experience with at least 3 years managed care experience2 4 years experience in utilization management required. Home health, SNF, and/or rehab experience desiredMedicare/Medicaid managed care programs preferred
Position is located telephonic in Franklin and/or remote Position is full-time during core business hours with the ability to work any shift between 7am and 6pm CST, plus mandatory on call responsibility after business hours equivalent to approximately two weekends per year. Ability to sit at a desk 90% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standingDependable and reliable work schedule is essentialTime-management: Ability to effectively manage one s time and resources to ensure that work is completed efficiently Excellent organizational skillsCommunication: Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadershipCritical-Thinking/Decision-making: Ability to choose a course of action or developing appropriate solutions by identifying and understanding issues, problems, and opportunitiesAutonomy: Ability to work independently with little to no supervisionProficient in computer literacy skills with ability to use and troubleshoot Microsoft Word, Excel, Outlook, and PowerPoint requiredExperience using videoconferencing systems such as WebEx
• Post ID: 134961622 queens