Clinical Services Review Nurse
MotivHealth
Date: 1 week ago
City: South Jordan, UT
Contract type: Full time
Overview: The Clinical Services Review Nurse position works directly with MotivHealth’s Medical Director to perform Utilization Management (UM) and Case Management (CM) functions.
Responsibilities And Duties
Responsibilities And Duties
- Performs clinical intake and reviews cases according to policies and procedures of MotivHealth
- Collects and enters confidential information ensuring the highest level of confidentiality in all areas
- Reviews clinical information against MotivHealth criteria and follows appropriate workflow
- Maintains written documentation according to MotivHealth’s documentation policy
- Provides quality customer service through interaction with members, providers, administrative staff, and others.
- Business focus demonstrates an understanding of the company’s vision, mission, and strategy
- Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others
- Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs
- Collaborates with Human Resources to ensure adherence to company policies
- Performs other related duties and projects as assigned
- Graduate of an accredited school of nursing
- Current active unrestricted RN license in a state or territory of the U.S.
- Five years of prior experience in direct clinical care or managed care setting required
- Excellent interpersonal, written and presentation skills, including the ability to handle interactions with facility personnel, providers, members, and various internal departments in a professional manner
- Ability to work in a fast-paced, evolving environment, on-call after hours work may be required
- Ability to utilize critical thinking skills
- Strong interpersonal and communication skills
- Highly motivated, self-starter who works independently using all available resources, policies, and procedures to work effectively and meet required timelines
- Minimum of 2 years of health care or health plan experience
- Knowledge of Microsoft Office and programs including Outlook, PowerPoint, Excel, and Word
- Easily able to adapt to change in a fast-growing company
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Sales Representative
Container One,
South Jordan, UT
$75,000
-
$225,000
per year
1 day ago
Benefits:Bonus based on performanceEmployee discountsFlexible scheduleTraining & developmentContainer One is a leading provider of shipping containers, shipping container accessories, and portable storage containers. We specialize in offering a comprehensive range of container solutions for storage, offices, housing, and other purposes. As a trusted industry leader, we serve three distinct markets: Commercial, Residential, and Agriculture. Our streamlined ordering process through our...
Server
Baskin Robbins,
South Jordan, UT
3 weeks ago
In most jobs, everyone doesn’t spontaneously erupt into applause and start raining down high-fives. At Buffalo Wild Wings, that’s just a Thursday night. This is the place to start the next phase of your career. Whether you grow in our system here or your game-plan takes you elsewhere, we want you to have an experience that lasts a lifetime.Game Time...
Cashier
Baskin Robbins,
South Jordan, UT
4 weeks ago
In most jobs, everyone doesn’t spontaneously erupt into applause and start raining down high-fives. At Buffalo Wild Wings, that’s just a Thursday night. This is the place to start the next phase of your career. Whether you grow in our system here or your game-plan takes you elsewhere, we want you to have an experience that lasts a lifetime.Game Time...