Clinical Utilization Management Nurse Reviewer
Location: Minnetonka Minnesota
Description: Clinicor is looking of Clinical Utilization Management Nurse Reviewer right now, this occupation will be placed in Minnesota. For detail informations about this occupation opportunity please read the description below. The Clinical Review Manager works within the framework of company’s multiple products to establish collaborative processes that promote quality and cost effective care.
This includes identification, assessment, planning, implementation/facilitation, coordination and evaluation of health related service options.
These activities require interfacing with members, providers, clinics, medical directors, intake staff, case managers and other departments within the company.
Performance is primarily measured by various quality audits, m! eeting regulatory requirements including but not limited to tu! rn around times, documentation standards, desired interventions impacted, volume of events/cases managed, and ad hoc feedback from members and providers.
General working knowledge of how various health care services link together (the health care continuum).
Experience working with multiple age groups, medical, surgical background and a generalized level of understanding across specialty care areas.
Strong customer service skills, strong decision making skills, active, listening skills, patience, independence and excellent organizational skills.
Ability to think creatively, negotiate and access resources
Excellent verbal and written skills.
Basic PC use and basic typing skills.
Ability to work independently.
Highly organized, time management skills, requires ability to make decisions under stress and manage multiple complex
issues on a daily basis.
Professional RN license in MN required.
Cer! tified Case Manager (CCM) preferred.
BSN or BS/BA preferred with a minimum of three years clinical experience or licensed professional with five
years clinical experience.
Managed care experience preferred.
Previous case management or utilization management experience and a broad base of clinical/hospital experience
Monday through Friday 8am â€" 5pm
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Clinicor.
If you interested on this occupation just click on the Apply button, you will be redirected to the official website
This occupation starts available on: Fri, 29 Nov 2013 17:59:40 GMT