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Pre-Cert Specialist Part-Time South (Registered Nurse Position) Mon - Fri 24 hours Job

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Date: Jul 1, 2019

Location: Memphis, TN, US

Company: Methodist Le Bonheur Healthcare

Summary

Responsible for problem solving methodologies and coordinating and monitoring prior authorizations for all aspects of patient care that pertain to hospital pre-admission and all levels of scheduled outpatient services, to monitor health care services that are deemed necessary, appropriate, effective and cost efficient according to the guidelines set forth by the insurance carrier. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

 

Education/Formal Training

Work Experience

Credential/Licensure

 

REQUIRED:

Graduate from an Accredited Nursing Program.

8 years clinical experience.

RN with current licensure in the State of Tennessee.

 

PREFERRED:

BSN

Prior experience in Case-management, Care Coordination, Care facilitation, and discharge planning.

Certified Case Manager

 

SUBSTITUTIONS ALLOWED:

N/A

N/A

N/A

Knowledge/Skills/Abilities

  • Positive working relationship and excellent interpersonal skills in working with physicians required.

  • Excellent written and verbal communication skills.

  • Ability to plan and schedule tasks and to maintain control of own work flow.

  • General PC skills; previous experience with Care Management/OCC software packages preferred.

  • Able to communicate information to groups of people in an educational setting.

  • Effective interpersonal relationship and skills.

Key Job Responsibilities

  • Assesses for opportunities to decrease fragmentation in delivery system, improveutilization of resources in order to improve quality of care.

  • Assesses for and performs necessary pre-certification and continued care reviews for assigned pre-admission and outpatient clientele in an appropriate manner and time frame.

  • Demonstrates initiative in identifying and pursuing opportunities for self-improvement and enhancement of professional competency; serves as a resource for department members and other members of the health care team.

  • Demonstrates effective customer relation skills, promotes a positive work environment, and contributes to the overall team effort.

  • Understands, applies, and supports departmental/hospital policies, procedures, and standards.

  • Actively participates in problem solving methodologies; identifies and communicates areas for improvement in ongoing efforts for quality care; assists in gathering, analyzing and presenting data in the assigned populations.

Physical Requirements

  • The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.

  • Must have good balance and coordination.

  • The physical requirements of this position are: medium work - exerting up to 50 lbs. of force occasionally and/or up to 25 lbs. of force frequently.

  • The Associate is required to have close visual acuity including color, depth perception, and field of vision to perform an activity, such as assessing patients, preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.

  • Frequent non-invasive patient contact.

  • Exposure to patient body fluids as well as exposure to hazardous or poisonous materials.

  • Ability to react quickly to emergency situations.


Nearest Major Market: Memphis

Job Segment: Nursing, Registered Nurse, Patient Care, Part Time, Healthcare