POSITION SUMMARY/RESPONSIBILITIES
Analyzes, coordinates, and documents care coordination services for patients based on established criteria, plan policies and procedures.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management and call center experience preferred. Experience in a similar setting preferred. Knowledge of e-mail, QM principles, and utilization management tools preferred. Claim review/audit experience a plus.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an LVN or RN is required.