UM/CM Coordinator
7 days ago
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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