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Job Summary

This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services required to meet an individuals health needs within the scope of their benefit plan.

JOB REQUIREMENTS

* Registered Nurse (RN) with current, valid, unrestricted license to practice in state of operations. * 3 years clinical practice experience. * Experience utilizing various software packages. * Verbal and written communication skills. * Analytical skills. * Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.

PREFERRED JOB REQUIREMENTS

* Familiarity with UM/CM activities and standardized criteria set. * Familiarity with NFLOC (Nursing Facility Level of Care) for New Mexico Medicaid

* Familiarity with LTSS (Long Term Support Services) for New Mexico Medicaid

* Proficiency in MS Office Products: Word, Excel, PPT, Outlook, etc.

#INKT

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Base Pay Range

$61,500.00 - $136,100.00

Exact compensation may vary based on skills, experience, and location.