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Clinical Utilization Review Nurse

2 months ago

Albuquerque, New Mexico, United States HireOps Staffing LLC Full time
Job Summary

We are seeking a skilled Nurse Case Manager Coordinator to join our team at HireOps Staffing LLC. As a key member of our healthcare team, you will be responsible for performing concurrent review, discharge planning, and identifying alternate treatment programs.

Key Responsibilities
  • Conduct episodic case management, consulting, and collaborating with providers, members, and other resources as appropriate.
  • Assess, plan, and implement options and services required to meet an individual's health needs within the scope of their benefit plan.
  • Utilize various software packages to manage and coordinate care.
Requirements
  • Registered Nurse (RN) with current, valid, unrestricted license in the state of operations or reciprocity.
  • 3 years of clinical experience.
  • Experience utilizing various software packages.
  • Verbal and written communication skills.
  • Analytical skills.
Preferred Requirements
  • Familiarity with UM/CM activities and standardized criteria set.
  • Knowledge of ancillary services including HHC, SNF, Hospice, etc.

We offer a competitive salary and a comprehensive benefits package. If you are a motivated and detail-oriented nurse with excellent communication skills, we encourage you to apply for this exciting opportunity.