Clinical Reviewer Nurse, CWOCN

Clinical Reviewer Nurse, CWOCN Integrated Home Care Acquisition - 2.6 Miramar, FL Job Details 1 hour ago Benefits Paid training Wellness program Paid holidays Health insurance Dental insurance Paid time off Vision insurance Life insurance Qualifications Word processing Spreadsheets Managing patients as a nurse case manager Overseeing care coordination Pre-authorization review for utilization management Utilization management Certified Wound, Ostomy, Continence Nurse Resource utilization in healthcare Health record tracking Concurrent review in utilization management Productivity software Managing patient records Care coordination Full Job Description Who we are: IHCS provides an Integrated Delivery System in the home setting, which includes, DME, Respiratory, Home Health and Home Infusion services. IHCS has a select network of Medicare and/or Medicaid Certified and Accredited providers to respond to the needs of our patients - 24/7. We operate with the sole intent of providing the highest quality in-home care services that improve and enhance the daily living for our patients, where our patients are #1 With over 30 years of experience, we are the trusted market leader in Home Health, Durable Medical Equipment, and Home Infusion Services. If you are passionate about inspiring, motivating, and leading teams this opportunity could be for you and we want to hear from you! Join our team as we strive for excellence through teamwork. We are committed to delivering high quality care to our patients through Exceptional Customer Service, Proven Outcomes, and Seamless Care. Full time team members competitive compensation package, include but not limited to; Medical, Vision, Dental, Short- and Long-term insurance 6+ Days of Holidays Pay PTO Employer paid life insurance 401K with employer contribution Wellness program with reward incentives Employee recognition and reward programs Comprehensive paid training program What will you be doing: As a Utilization Management Nurse, CWOCN you will ensure that home health care services are administered with quality, cost efficiency, and within compliance. By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won't receive unnecessary procedures, ineffective treatment, or unnecessarily extensive home healthcare.

Qualifications:

At least 2-3 years of wound, ostomy, or continence experience; CWOCN certification. Concurrent review of patient's clinical information for efficiency Ongoing review of precertification requests for medical necessity Coordinates patient care needs with a multi-disciplinary healthcare team Maintain accurate records of all patient related interactions Ability to stay organized and interact well with others in any situation Provide updates to Manager of Utilization Management for review What will you come with: State licensure as a LPN or

RN CWOCN

Certification required Minimum 2 years of prior experience in Utilization Management Strong knowledge of word processing and spreadsheet computer programs Utilization Management or Case Management certification preferred Join our team as we strive for excellence through teamwork, where our patients are #1! IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. #IND Experience Required Strong knowledge of word processing and spreadsheet computer programs Utilization Management or Case Management certification preferred 2 year(s): experience in Utilization Management State licensure as a

LPN or RN Behaviors Preferred Team Player:

Works well as a member of a group

Enthusiastic:

Shows intense and eager enjoyment and interest

Detail Oriented:

Capable of carrying out a given task with all details necessary to get the task done well

Dedicated:

Devoted to a task or purpose with loyalty or integrity Motivations Preferred Ability to Make an

Impact:

Inspired to perform well by the ability to contribute to the success of a project or the organization

Growth Opportunities:

Inspired to perform well by the chance to take on more responsibility Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.