RN Care Management Coordinator- AHA
KNOWLEDGE SKILLS AND ABILITIES:
Experience:
· Minimum Five years clinical experience or equivalent (Intensive Care, Trauma, Home Health a plus) required
· Medical management/precertification experience preferred
· Oriented in current trends of medical practice
· Active PA Licensed Registered Nurse required
Skills:
· Strong problem solving and critical thinking abilities
· Proficiency utilizing Microsoft Word, Outlook, Excel, Access, SharePoint, and Adobe programs.
· Excellent organizational planning and prioritizing skills
· Ability to work independently and provide positive resolution of complex medical and interpersonal challenges
· Highly professional interpersonal skills for internal and external contacts, particularly in situations where medical evaluations are in conflict with treating providers proposed treatment plans
· Participates in the process of educating providers on managed care
· Comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable.
· Builds team spirit and interdepartmental rapport, using effective problem solving and motivational strategy
· Performs additional job-related duties as assigned
Education: Registered nurse, BSN Preferred
The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required.
Inclusion and Belonging
At AmeriHealth Administrators, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
AmeriHealth Administrators is one of the largest national third-party administrators providing innovative, value-based health benefits programs and outsourcing services for self-funded health plans and other organizations.
The company also provides customized outsourcing services for TPAs and other payers, student health plans, and fully insured products.
AmeriHealth Administrators serves 1 million plan members in all 50 states and processes over 6 million claims annually.
Equal Employment Opportunity
AmeriHealth Administrators is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Administrators employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Administrators and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Administrators or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.