Nurse Care Manager
4 weeks ago
Care Management Role at USA Health
USA Health is seeking a skilled Registered Nurse to join our team as a Care Manager. In this role, you will be responsible for coordinating patient care and ensuring optimal reimbursement from third-party payors.
Key Responsibilities:
- Perform quality reviews, prior authorizations, and initial/admission reviews to ensure accurate and timely care.
- Analyze medical record data to complete functions and collaborate with healthcare teams to formulate discharge plans.
- Communicate with healthcare providers and third-party payor representatives to ensure optimal reimbursement.
- Participate in interdisciplinary patient care meetings and utilize a PC to access the Hospital Information System.
- Enhance professional growth and development through participation in educational programs.
Qualifications:
- Graduation from an accredited school of nursing and licensure with the state of Alabama as a registered nurse.
- Two years of professional nursing experience and previous utilization review experience preferred.
USA Health is an Equal Opportunity Employer
USA Health is committed to providing a safe and inclusive work environment for all employees. We do not discriminate on the basis of race, color, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, religion, age, genetic information, disability, protected veteran status, or any other applicable legally-protected basis.
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