RN Medical Services Coordinator, Mercycare Building, Day Shift, 80Hrs/2Wks

Mercy Health System Janesville , WI 53548

Posted 2 months ago

JOB SUMMARY Responsible for coordinating utilization review (UR), case management and NCQA/quality initiative activities for all managed products.# Attends and contributes as required to physician committees such as medical management as assigned.# ESSENTIAL DUTIES AND RESPONSIBILITIES # Demonstrates commitment to quality by providing excellent service to internal and external customers.# Ensures all work activities are consistent with managed care policies and philosophy follows directives from the legal department and is responsible for all extra contractual arrangements.# Completes work accurately and in a timely manner.# EDUCATION, TRAINING, # EXPERIENCE CERTIFICATION/LICENSURE########## # Registered Nurse, actively licensed in the state of Wisconsin, BSN degree preferred or enrolled in a BSN program; knowledge of health care delivery systems, medical necessity criteria application and legal consideration, surrounding managed care# proven excellence in communication; these skills include writing, speaking and presenting to professionals, demonstrates ability to work within a team environment.

JOB SUMMARY

Responsible for coordinating utilization review (UR), case management and NCQA/quality initiative activities for all managed products. Attends and contributes as required to physician committees such as medical management as assigned.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Demonstrates commitment to quality by providing excellent service to internal and external customers. Ensures all work activities are consistent with managed care policies and philosophy follows directives from the legal department and is responsible for all extra contractual arrangements. Completes work accurately and in a timely manner.

EDUCATION, TRAINING, & EXPERIENCE CERTIFICATION/LICENSURE

Registered Nurse, actively licensed in the state of Wisconsin, BSN degree preferred or enrolled in a BSN program; knowledge of health care delivery systems, medical necessity criteria application and legal consideration, surrounding managed care' proven excellence in communication; these skills include writing, speaking and presenting to professionals, demonstrates ability to work within a team environment.

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RN Medical Services Coordinator, Mercycare Building, Day Shift, 80Hrs/2Wks

Mercy Health System