What are the responsibilities and job description for the Utilization Management Nurse position at Innovative System Group?
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 require to meet an individuals health needs within the scope of their benefit plan.
JOB REQUIREMENTS:
- Familiarity with UM/CM activities and standardized criteria set.
- Knowledge of ancillary services including HHC, SNF, Hospice, etc.
- Registered Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.
- 3 years of clinical experience
- Experience utilizing various software packages.
- 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 HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.
- Verbal and written communication skills
- Analytical skills
Job Type: Full-time
Pay: $35.00 - $38.00 per hour
Experience:
- Psychiatric care: 3 years (Required)
Work Location: In person
Salary : $35 - $38
