Case Management - Nursing
Location: Albuquerque New Mexico
Description: Loyal Source Government Services is at the momment seeking for Case Management - Nursing right now, this occupation will be placed in New Mexico. More details about this occupation opportunity please give attention to these descriptions. Case Management opening in Albuquerque, New Mexico. Loyal Source Government Services is currently hiring multiple RN\\\'s for the Utilization Management! department at Kirtland AFB in Albuquerque, NM. To apply please contact Justin LaMacchia at [Click Job Title to Apply] ext 113 or by email at [Click Job Title to Apply]These opportunities offer a Registered Nurse - Utilization Management excellent stability, great compensation and benefits packages and a great work environment serving a patient population of active duty Air Force members and beneficiaries.Company Info: Loyal Source Government Services prides itself on providing elite medical services to the Department of Defense, Department of Veterans Affairs, and other federal agencies. Loyal Source is a prime contract holder on the Air Force medical services contract and is currently hiring all medical specialties throughout the United States. As a member of the Loyal Source team you will have the unique opportunity to provide healthcare to the men and women who protect and serve our country along with their families. In addition to this great honor, Loyal Source provide! s excellent compensation and benefits. For more company inform! ation please visit our website at [Click Job Title to Apply] OUR NAME “Loyalty is willing in that it is freely given, not coerced. It is chosen after personal consideration, not something that one is born into. Loyalty is practical in that it is practiced. It is actively engaged upon, not passively expressed merely as a strong feeling about something. Loyalty is thoroughgoing in that it is not merely a casual interest but a wholehearted commitment to a cause.\\\" -RoyceJob RequirementsQUALIFICATIONS.Must have knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]), and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC), The Joint Commission (TJC), and Clinical Practice Guidelines (CPGs); computer applications/software to include Microsoft Office programs, MS Outlook (e-mail), and internet familiarity; Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), Interna! tional Classification of Diseases-Current Version (ICD), and Current Procedural Terminology-Current Version (CPT) coding; and McKesson (InterQual) and/or Milliman Care Guidelines.Must have experience in Patient Advocacy, Patient Privacy, and Customer Relations; performing prospective, concurrent, and retrospective reviews to justify medical necessity for requested medical care and to aid in collection and recovery from multiple insurance carriers; inpatient unit rounds for clinical data collection; providing documentation for appeals or grievance resolution; applying critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations; applying problem-solving techniques to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way.Education. Shall be a graduate from an associate (ADN) or baccalaureate degree (BSN) program in nursing accred! ited by a national nursing accrediting agency recognized by the US Depa! rtment of Education.License. Maintain an active, valid, current, and unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction.Experience. A minimum of 3 years for ADN or 2 years for BSN full-time experience in utilization management/utilization review or in broad-based clinical nursing.Certification. Certified Professional in Healthcare Management (CPHM) by McKesson or a clinical specialty recognized by American Nurses Credentialing Center -OR- certification eligible with 3 years for ADN or 2 years for BSN experience in utilization management/utilization review or in broad-based clinical nursing.
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If you were eligible to this occupation, pl! ease email us your resume, with salary requirements and a resume to Loyal Source Government Services.
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This occupation starts available on: Sat, 29 Jun 2013 13:46:03 GMT