Clinical Nurse Specialist

4 weeks ago


Hollywood, Florida, United States Medix Full time
Job Summary

We are seeking a skilled Inpatient Nurse Case Manager to join our team at Medix. This role involves assessing patient records, coordinating with healthcare providers, and adhering to regulatory guidelines to secure authorization from insurance for continued inpatient care at the hospital.

Responsibilities
  • Partner with medical staff to ensure optimal patient outcomes
  • Develop and implement patient-focused long-term and short-term goals
  • Collect and report utilization data and quality information
  • Assist in preparing UM/QI case issues and gathering requested records/responses
  • Provide instruction to hospitalized members and their families, and serve as liaison between the member, physician, hospital, and Plan
Requirements
  • Active CA Registered Nurse or LVN license required
  • Acute clinical experience
  • Experienced in case management, UR/UM
  • Possesses knowledge of applicable regulatory standards and is able to perform audits based upon these standards
  • Solid experience dealing with UR concepts
  • Computer literate
  • Excellent verbal and written communication skills
Benefits
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Flexible schedule
  • Flexible spending account
  • Health insurance
  • Health savings account
  • Life insurance
  • Paid time off
  • Tuition reimbursement
  • Vision insurance


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