Job Details

ID #4178506
Estado New York
Ciudad Melville
Full-time
Salario USD TBD TBD
Fuente Anthem, Inc.
Showed 2020-06-19
Fecha 2020-06-19
Fecha tope 2020-08-18
Categoría Etcétera
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NICU In-Patient Concurrent Review Nurse RN PS36067

New York, Melville 00000 Melville USA

Vacancy caducado!

Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company. NICU In-Patient Concurrent Review Nurse RN PS36067Location: This position will allow you to work from home. Nevada State preferred. Required Work Hours: Pacific Coast Time Zone - 8am - 5pm, Monday - Friday. You will be responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care for NICU/Peds population Primary duties may include, but are not limited to: Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Ensures member access to medical necessary, quality healthcare in a cost effective setting according to contract. Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process. Collaborates with providers to assess members’ needs for early identification of and proactive planning for discharge planning. Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications. Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards. Works with medical directors in interpreting appropriateness of care for NICU/Peds populationQualifications Requires: Current, active unrestricted Nevada State RN license and a current unrestricted RN license in the state where you reside. Minimum 2 years acute care clinical experience in NICU/Peds Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills Strong computer skillsPreferred: Utilization Management experience strongly preferred MCG or Interqual experience strongly preferred Managed care Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. REQNUMBER: PS36067-US

Vacancy caducado!

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