| Job Listings |
| Job Number |
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000044XM |
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| Job Title |
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RN Nurse Case Manager |
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Location |
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Roseburg, OR |
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| Description |
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RN NURSE CASE MANAGER
Requirements:
Current OR RN License, recent nursing experience with a varied background in nursing.
Hire date:
Position: Full-time
8am -5 pm Monday to Friday, possible variation in hours due to staffing
One hour lunch, not paid and two 10 minute breaks, paid.
Over-time needs prior approval by the supervisor.
Wage: per hour starting plus Company benefits.
Job Description: RN, NCM for OHP & ATRIO
Reports to: Medical Management Supervisor and Medical Director
First review: 3 months from starting date then 12 months later. Date may vary
depending on level of performance.
Specific Duties:
" Review and process requests for services for both Medicare and Medicaid members.
" Use of various computer programs for communication, documentation, research, and claims.
" Review member's medical records for information to document that requested services meet guidelines.
" Obtain additional documentation from various sources including: labs, hospital records, and out-patient facilities.
" Present requests with appropriate documentation to the medical review team on a daily basis. Approve authorizations per the medical director's guidelines. Deny requests only at the medical director's direction.
" Attend and participate in state and community meetings as assigned. This may require occasional out- of-town travel.
" Participate in case management conferences held by Company, providers, or state agencies.
" Assist the medical director with research and special projects.
" Assist the Quality Improvement coordinator with the annual DMAP Quality Improvement Evaluation. This includes pamphlet distribution and participation in staff education.
" Report information regarding additional insurance coverage to the Third Party Recovery coordinator.
" Other duties as determined by the administrative staff. Specific job duties can change according to the needs of Companies Medical Management Team. |
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| Salary Range |
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$0.00 to $0.00 |
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Are you interested in this position? Please contact the recruiter for this position by e-mail at amber@personnelsource.com, please include a copy of your resume. It is recommended that you also have an application on file with us. Please complete our application once only as it will be used to match your qualifications against all of our job openings and will remain on file for 90 days.
Personnel Source, Inc. is an equal opportunity employer. All qualified applicants will receive consideration without discrimination on the basis of gender, marital status, race, age, creed, national origin or the presence of disabilities.
Last Update: November 17, 2008 |
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