Job Description

Need candidates from Northern Richmond in areas like Henrico, Lakeside, Tuckahoe Counties.

Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues

Determines medical necessity/ appropriateness Facilitates optimal outcomes Identifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective action Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy Optimize total costs Implementation and evaluation of policy based on usage and program directives Educate/empower colleagues at all levels to enable decision making at most appropriate level

Position Summary:

Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively

manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues

Duties:

Determines medical necessity/ appropriateness

Facilitates optimal outcomes

Identifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective action

Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy

Optimize total costs

Implementation and evaluation of policy based on usage and program directives

Educate/empower colleagues at all levels to enable decision making at most appropriate level

Experience:

- Minimum 3 years of relevant experience

Education:

RN Licensure

Associates degree or higher

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