Remote – PRN Position

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Role and Responsibilities:

• Ideal candidate must have hospital case management experience and solid utilization review experience applying evidenced based criteria sets along with experience determining level of care and medical necessity
• Work collaboratively with interdisciplinary and healthcare team members, both internal and external to the organization
• Facilitate patient care through effective utilization and monitoring of healthcare resources
• Coordinate care and services through the acute care episode and across the continuum.

Qualification and Education Requirements:

• Graduate of approved accredited nursing program, BSN preferred but not required
• Current license to practice as a Registered Professional Nurse

Preferred Skills:

• Broad clinical training and work experience sufficient to provide background in clinical management, continuing care and transitions of care
• Familiarity with health care insurances and regulations desirable
• Demonstrate knowledge of the principles of growth and development over the life span and can identify each patient’s age-specific needs

General Requirements:

• Commitment and reliability; be able to dedicate consistent time to HIA
• Superb communication and responsiveness
  Computer literacy
• Must be comfortable with, but not limited to: Excel, web-browsers, email, electronic health records (non-specific)
• Must be familiar with various technologies such as, but not limited to: security (e.g., Citrix), data collection/abstraction, encoders, web-based applications
• Self-maintenance of skillset
• Maintaining credentials
• Staying current with abstraction/coding rules, manuals, and guidelines
• Prior experience in position applying for
• Motivation; remote work can be team-based, but requires the ability to work independently
• Strong interpersonal skills and tactfulness to be able to effectively communicate with team members and client contacts

Educational Requirements:

• A college degree from
• An accredited nursing program,
• CAHIIM accredited program, or
• Other accredited healthcare program
• Healthcare credential associated with their program of study
• Other healthcare information related abstraction and coding credentials desirable