Blue Cross and Blue Shield of Illinois, Montana, N Care Coordinator UM/CM I (RN) in Chicago, Illinois
This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning and identifying alternate treatment programs, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services required to meet an individuals health needs within the scope of their benefit plan. Contact list of providers to manage out of network requests by providing alternative in network options.
- Registered Nurse (RN) with current, valid, unrestricted clinical license to practice in state of operations.* 3 years clinical practice experience.* Experience utilizing various software packages.* Verbal and written communication skills.* Analytical skills.* Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.
PREFERRED JOB REQUIREMENTS:
- Familiarity with UM/CM activities and standardized criteria set.* Knowledge of ancillary services including HHC, SNF, Hospice, etc.
Location: IL - Chicago, TX - Richardson
Activation Date: Friday, December 7, 2018
Expiration Date: Tuesday, January 8, 2019