Primary Nurse Case Admin I - IL, NM, TX

This position is responsible for performing all functions of Utilization Management (UM), Case Management (CM) and Disease Management (DM) and is a single source of contact for members, health care personnel and all other entities involved in managing care.

Requirements

• Registered Nurse (RN) with current, valid, unrestricted license in state of operations
• 2 years clinical practice experience of direct clinical care to the customer
• 1 year experience in Condition Management or Case Management in a health insurance, managed care, physician office or hospital setting
• PC proficiency to include Word, Excel, Lotus Notes and database experience
• Clear and concise verbal and written communication skills
• Knowledge of UM/CM/DM activities and standardized criteria set
• Familiarity of ancillary services including HHC, SNF, Hospice, etc
• Verbal and written communication skills; analytical skills; sound clinical judgment

Benefits

• Health and wellness benefits
• 401(k) savings plan
• Pension plan
• Paid time off
• Paid parental leave
• Disability insurance
• Supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement
• Other incentives

Originally posted on Himalayas