Job Summary
A healthcare company has a current position open for a Virtual RN Quality Improvement and Dedicated Care Manager in Shreveport.
Core Responsibilities Include:
- Reviewing actual and proposed medical care and services against established CMS Coverage Guidelines
- Directing referrals to participating sub-specialists outside of the engaged provider group
- Identifying and directing referrals of members with a readmission to a provider group PCP for follow-up evaluation
Position Requirements Include:
- Travel: Yes, 50 % of the Time
- RN with active license and no restrictions
- 5 years of recent direct patient care experience in an Integrated Delivery System, an MSO or an acute IP facility
- Excellent and proven ability to communicate, problem-solve, and negotiate
- Proven ability to work successfully within multidisciplinary teams as well as independently
- Able to resolve difficult clinical and social issues with patients, patients families and physicians efficiently and effectively
