UM/CM Coordinator

7 days ago


Albuquerque, United States Innovative Systems Group Full time

Work Location: 5701 Balloon Fiesta Parkway, Albuquerque, NM 87113

On-site

Contract: 2024-07-01 to 2024-12-31


This position is responsible for performing concurrent review in accordance with accepted department criteria; 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 individual's health needs within the scope of their benefit plan.


JOB REQUIREMENTS:

  • Registered Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.
  • Must be licensed in NM. With current, valid, unrestricted license in NM.
  • 3 years of clinical 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 the company. 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.
  • Knowledge of ancillary services including HHC, SNF, Hospice, etc.


* Training is completed through WebEx precepting. The worker should be able to hit the ground running.


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