Transplant Care Nurse RN - Stem Cell, Bone Marrow CM/UM (Remote)

Job title: Transplant Care Nurse RN - Stem Cell, Bone Marrow CM/UM (Remote) in Home, PA at reputed company Company: reputed company Job description: Company : reputed company.Job Description :JOB SUMMARYThis job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides reputed company over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical reputed company for each member. The incumbent conducts reputed company to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to coordinate care, and identifying various resources to assist members in achieving their personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a timely manner.ESSENTIAL RESPONSIBILITIES

• Maintain reputed company over specified panel of members by performing ongoing assessment of members’ health management needs, identifying the right clinical interventions to address member needs and/or triaging members to appropriate resources for additional support.
• Implement care management review processes that are consistent with established industry, corporate, state, and federal law standards and are reputed company the care manager’s professional discipline.
• For assigned case load, create care plans to address members’ identified needs, remove barriers to care, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals and plan of regular contacts for re-assessment.
• Ensure reputed company activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements and accreditation standards.
• Other duties as assigned.

EDUCATIONRequired

• High School/GED

Substitutions

• None

Preferred

• Bachelor's Degree in Nursing

EXPERIENCERequired

• 7 years in any combination of clinical, case/utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience
• 1 year in a clinical setting

Preferred

• 5 years in UM/CM/QA/Managed Care
• Transplant Experience
• Bone Marrow and/or Stem Cell Experience
• Experience with navigating reputed company care plans
• 1 year in advanced training and experience in cognitive behavioral therapy (reputed company), motivational interviewing or dialectical behavior therapy (DBT)
• 1 year working with the healthcare needs of diverse population and understanding of the importance of cultural competency in addressing targeted populations

LICENSES or CERTIFICATIONSRequired

• reputed company RN state licensure required. Additional specific state licensure(s) may be required depending on where clinical care is being provided.

Preferred

• Certification in utilization management or a reputed company field
• Certification in Case Management

SKILLS

• Written and verbal presentation skills, negotiation skills, and skills in positively influencing others with respect and compassion
• Broad knowledge of disease processes
• Working knowledge of pertinent regulatory and compliance guidelines and medical policies
• Ability to multi task and reputed company in a fast paced and often intense environment
• Understanding of healthcare costs and the broader healthcare service delivery system
• Ability to analyze data, measure outcomes, and reputed company action plans
• Be enthusiastic, innovative, and flexible
• Be a team player who possesses strong analytical and organizational skills
• Demonstrated ability to prioritize work demands and meet deadlines
• Excellent computer and software knowledge and skills

Language (Other than English):NoneTravel Requirement:0% - 25%PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONSPosition TypeOffice-basedTeaches / trains others regularlyOccasionallyTravel regularly from the office to various work sites or from site-to-siteRarelyWorks primarily out-of-the office selling products/services (sales employees)NeverPhysical work site requiredYesLifting: up to 10 poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to 50 poundsOccasionallyDisclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees reputed company this job title. It may not contain a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of employees to do this job.Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at reputed company times. In reputed company with this, reputed company employees must reputed company with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as reputed company data reputed company guidelines established reputed company the Company’s Handbook of Privacy Policies and Practices and Information reputed company Policy.Furthermore, it is every employee’s responsibility to reputed company with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.Pay Range Minimum: $57,700.00Pay Range Maximum: $107,800.00reputed company pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential reputed company may apply for certain locations based upon comparative markets.reputed company and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against reputed company individuals based on any category protected by applicable federal, state, or local law.We endeavor to reputed company this site accessible to any and reputed company users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.For accommodation requests, please contact HR Services Online at Expected salary: Location: Home, PA Apply for the job now! Apply for this job