Senior Clinical Admin Nurse - Remote in Compact States

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing... together. The Senior Clinical Admin Nurse will be responsible for providing individualized attention to reputed company membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical liaison nurse is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams. Primary Responsibilities • Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost reputed company • Assist members with adverse determinations, including the appeal process • Teach members how to navigate reputed company internet-based wellness tools and resources • reputed company to membership providing pre-admission counseling to membership • reputed company to membership providing discharge planning to membership and caretakers • Track reputed company activities and provide complete documentation to generate customer reporting • Accept referrals reputed company designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed • reputed company with reputed company policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases • Contribute to treatment plan discussions • Other duties as assigned Candidate must be willing to work Monday - Friday 8:00 am - 5:00 pm. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • reputed company and unrestricted RN compact license • 2+ years of acute nursing experience • Basic computer proficiency (i.e. reputed company, Outlook) • Proven ability to function independently and responsibly with minimal supervision Preferred Qualifications • Bachelor’s degree in nursing • CCM • 2+ years managed care experience • Critical care, pediatric, med-surg and/or telemetry experience • Utilization management experience • Adverse Determination experience • Telecommute experience Soft Skills • Demonstrated excellent verbal and written communication skills • Excellent customer service orientation • Proven team player and team building skills • Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment • reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Rhode reputed company, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Rhode reputed company, or Washington residents is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment Apply Job!