What are the responsibilities and job description for the Nurse Care Coordinator position at NWDC IPA?
Responsibilities: Participates in the entirety of processing outpatient and inpatient Organizational Determinations for contracted health plan(s). Conducts integrated health care review and evaluation. Assess medical necessity of referrals for Organizational Determinations. Utilizes and applies endorsed criteria.
Licensing: Current LVN or RN license required.
Work Experience: Prefer at least 6 months experience in managed care referral/authorization processing.
Hybrid workplace. Primary work is from home/remote. Training will take place at office, other in person meetings as needed.
Job Type: Full-time
Pay: $65,000.00 - $78,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- Monday to Friday
COVID-19 considerations:
We are primarily working remotely. COVID-19 Screening process (temperature/symptom check) in place when entering the office.
Application Question(s):
- Do you have Milliman Care Guidelines and/or Interqual experience?
Experience:
- Managed care: 1 year (Preferred)
License/Certification:
- LVN or RN license (Required)
Work Location: One location
Salary : $65,000 - $78,000