Case Management - Nursing
Location: Colorado Springs Colorado
Description: Loyal Source Government Services is at present looking to employ Case Management - Nursing right now, this career will be placed in Colorado. Further informations about this career opportunity kindly see the descriptions. Case Management opening in Colorado Springs, Colorado. Loyal Source Government Services is currently hiring an RN - Utilization Management at Peterson AFB in Colorad! o Springs, CO.To apply please contact Cassandra Reschke at [Click Job Title to Apply] ext 102 or by email at [Click Job Title to Apply]This opportunity at Peterson Air Force Base offers a Registered Nurse - Utilization Management excellent stability, great compensation and benefits packages and a great work environment serving a patient population of active duty Air Force members and beneficiaries.QUALIFICATIONS.- Must have knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]), and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC), The Joint Commission (TJC), and Clinical Practice Guidelines (CPGs); computer applications/software to include Microsoft Office programs, MS Outlook (e-mail), and internet familiarity; Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), International Classification of Diseases-Current Version (ICD), and Current Procedural Terminolo! gy-Current Version (CPT) coding; and McKesson (InterQual) and/! or Milliman Care Guidelines.- Must have experience in Patient Advocacy, Patient Privacy, and Customer Relations; performing prospective, concurrent, and retrospective reviews to justify medical necessity for requested medical care and to aid in collection and recovery from multiple insurance carriers; inpatient unit rounds for clinical data collection; providing documentation for appeals or grievance resolution; applying critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations; applying problem-solving techniques to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way.- Education. Shall be a graduate from an associate (ADN) or baccalaureate degree (BSN) program in nursing accredited by a national nursing accrediting agency recognized by the US Department of Education.- License. Maintain an active, valid, current, and unres! tricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction.- Experience. A minimum of 3 years for ADN or 2 years for BSN full-time experience in utilization management/utilization review or in broad-based clinical nursing.- Certification. Certified Professional in Healthcare Management (CPHM) by McKesson or a clinical specialty recognized by American Nurses Credentialing Center -OR- certification eligible with 3 years for ADN or 2 years for BSN experience in utilization management/utilization review or in broad-based clinical nursing.
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to Loyal ! Source Government Services.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Thu, 04 Jul 2013 13:22:50 GMT