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
Requirements:
- RN with current unrestricted state licensure required, BH experience helpful.
- Minimum 3 years of relevant experience
