Lifelancer — өмір туралы ғылымдар, фармацевтика және IT салаларына бағытталған, жасанды интеллектпен жұмыс істейтін кадрларды жалдау платформасы. Ол білікті мамандарға өз тәжірибесін таныстыруға, халықаралық жұмыс пен жоба мүмкіндіктерін іздеуге және арнайы білімі бар мамандарды іздейтін жұмыс берушілермен байланысуға көмектеседі. Жұмысқа қабылдау топтары үшін Lifelancer жасанды интеллект көмегімен мамандарды іздеуді бірнеше елде жұмысқа қабылдау және еңбекақы төлеу үдерістерін қолдаумен біріктіреді, соның ішінде талаптарға сәйкестікке қатысты мәселелер де бар.
Behavioral Health Utilization Management Nurse Consultant
Review inpatient and outpatient behavioral health care for managed-care members, applying clinical criteria to service authorization and provider escalations. This remote role serves CVS Health members in Arizona.
Сипаттама
- Review inpatient and outpatient services requiring precertification using evidence-based criteria and clinical guidelines.
- Authorize procedures and services based on applicable criteria, or refer cases to a Medical Director.
- Gather and assess clinical information from providers.
- Work with providers and escalate cases when needed.
- Use multiple systems and keep records accurate.
- Conduct utilization reviews in a fast-paced, computer-based setting.
- Perform desk and telephone duties, including sitting, speaking, listening, and computer use.
Талаптар
- Hold an active, unrestricted Registered Nurse license in your state of residence.
- Have at least 3 years of acute behavioral health and/or substance abuse clinical nursing experience.
- Have at least 1 year of concurrent review or prior authorization experience; behavioral health and substance abuse experience is preferred.
- Attend all sessions of mandatory three-week training, Monday through Friday, 8:30 a.m. to 5:00 p.m. Eastern Time.
- Be able to provide occasional rotating on-call coverage on weekends and some holidays.
- Have an associate degree in nursing (RN).
- Be proficient with computers and able to navigate multiple systems.
- Maintain a dedicated workspace free from interruptions.
- Arrange separate care for dependents during work hours.
- Preferred: At least 1 year of managed care organization experience.
- Preferred: At least 1 year in a high-volume clinical call center.
- Preferred: Remote work experience.
- Preferred: Bachelor of Science in Nursing.
Артықшылықтар
- Medical coverage.
- Dental coverage.
- Vision coverage.
- Paid time off.
- Retirement savings options.
- Wellness programs.
- Resources supporting physical, emotional, and financial well-being.
- Eligibility for CVS Health bonus, commission, or short-term incentive programs.