LVN/RN Case Coordinator - Birmingham, AL
Location: Birmingham Alabama
Description: Cigna is currently interviewing LVN/RN Case Coordinator - Birmingham, AL right now, this position will be placed in Alabama. For detail informations about this position opportunity please read the description below. Job Description
Responsible for the effective and sufficient support of all utilization management activities to include prospective/ pre-certification re! view of inpatient and outpatient medical services for medical necessity and appropriateness of setting according to established policies. Using an established set of criteria, evaluates and authorizes the medical necessity of inpatient and outpatient services. Notifies provider of recommended changes in level of care. Evaluates cases for quality of care and documents quality issues. Issues letter to provider if the service meets certification criteria, and escalates to manager or Medical Director for review if the service does not meet certification criteria. .
Requirements
Minimum Requirements: Current licensure as a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). At least one year clinical experience.
Preferred Requirements: Current licensure as a Registered Nurse (RN). Managed care experience. Two years experience in utilization review. Knowledge of ICD-9 and CPT Coding guidelines. .
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If you were! eligible to this position, please email us your resume, with ! salary requirements and a resume to Cigna.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Sat, 05 Oct 2013 14:16:57 GMT