Utilization Management Nurse RN

Mindlance; United States; Remote; USD 61,992 - 62,680; Part time

Job summary

A healthcare staffing agency is seeking a remote Nurse Case Management Senior Analyst to deliver healthcare services in coordination with treatment plans. The ideal candidate will have a nursing license and at least two years of experience in Utilization Management. Responsibilities include managing caseloads and ensuring quality care outcomes. This position offers a contract duration of 5-6 months with a competitive pay rate of $45.00/hr - $45.50/hr.

Qualifications

• 2 years of experience in Utilization Management.
• Experience with MCG or Interqual preferred.
• Current RN license is required.

Responsibilities

• Plans, implements, and evaluates health care services.
• Assesses and coordinates care options for members.
• Manages own caseload and resolves issues.

Skills

MCG or Interqual Experience

Utilization Management Experience (2 years)

Education

Current unrestricted nursing license

Job description

Overview

Job Title: Nurse Case Management Senior Analyst

Location: REMOTE

Duration: 5-6 Months (Contract possibly Extension)

Schedule: Monday - Friday 8am-5pm (EST or CST); no weekends, evenings, or overtime. 8 hours per day, 40 hours per week.

Base pay range

$45.00/hr - $45.50/hr

Job Profile Summary

• Nurse Case Management Senior Analyst
• Delivers specific delegated tasks assigned by a supervisor in the Nurse Case Management job family.
• Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan.
• Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members.
• Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.
• Provides clinical assessments, health education, and utilization management to members.
• Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services.
• Manages own caseload and coordinates all assigned cases.
• Completes day-to-day Nurse Case Management tasks without immediate supervision, but has ready access to advice from more experienced team members.
• Tasks involve a degree of forward planning and anticipation of needs/issues.
• Resolves non-routine issues escalated from more junior team members. RN and current unrestricted nursing license required.

Required Qualifications

• MCG or Interqual Experience, 2 years of Utilization Management Experience.

EEO

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”

Employment details

• Seniority level: Mid-Senior level
• Employment type: Contract
• Job function: Analyst and Health Care Provider
• Industries: Hospitals and Health Care

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