POSITION SUMMARY/RESPONSIBILITIES

Analyzes, coordinates, and documents care coordination services for patients based on established criteria, plan policies and procedures.

EDUCATION/EXPERIENCE

-Graduation from an accredited school of nursing, RN or LVN is required.

-A minimum three years of clinical nursing experience is required.

-Data entry, referral management, utilization management experience is required.

-Case management and call center experience preferred.

-Knowledge of e-mail, QM principles, and utilization management tools preferred.

-Claim review/audit experience a plus.

LICENSURE/CERTIFICATION

 -Current licensure in the State of Texas as an RN or LVN is required.