Children's Mercy Hospitals and Clinics

Care Facilitation Nurse (CMH ICS-CARE INTEGRATION) (44592323)
Location: Kansas City, Missouri - United States
Posted: 12/12/2017

Care Facilitation Nurse (CMH ICS-CARE INTEGRATION)

80 Day shift
Job Responsibilities:
The Care Facilitation Nurses' primary duties are to perform prior authorization functions for inpatient and outpatient services, using evidence-based clinical criteria. This requires attention to detail and adherence to established timelines and required documentation standards. The Care Facilitation Nurse will work in collaboration with the provider offices by providing education on the prior authorization process, facilitating referrals to network providers, providing member outreach to identify and screen members with complex needs for enrollment into Care Integration programs, and sharing of pertinent patient information with care teams to enhance coordination of care. This position shall work closely with all areas of the Care Integration department, providers, other health care professionals, and members/caregivers.

Job Requirements:

Associate's degree required
Bachelor's degree preferred
3 -5 years' work related experience

Experience as a nurse with health plan experience in prior authorization and/or a clinical setting, such as inpatient hospital, clinic etc. with demonstrated skills in attention to detail and coordination of care across multiple settings
Registered Nurse licensure in Missouri and Kansas required
EEO Employer/Disabled/Vet

Additional Requirments / Information

Job Capacity:Employee (full-time)
Minimum Education Level:See Job Description
Visa Sponsorship: No
Related Industries:Professional Services
No Profile Available

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