Sep 2, 2012

Case Managers / Utilization Review Nurse Auditors

Employee Type :  Full-Time Industry :  Healthcare - Health Services Manages Others :  No Job Type :  Health Care Experience :  Not Specified Relocation Covered :  No Post Date :  9/2/2012 Contact Information Ref ID : 0000170806-01-1  Description View Original Newspaper Ad

inVentiv
MEDICAL
MANAGEMENT

INVENTIV HEALTH

Are you an articulate and self-motivated nurse that would like to work from home?

inVentiv Medical Management is currently seeking experienced Case Managers and Utilization Review Nurse Auditors.

inVentiv Medical Management, based in Augusta, Georgia and a wholly owned subsidiary of inVentiv Health. inVentiv Medical Management has been a pioneer in the world of medical cost containment. We deliver cutting-edge programs and services to set our clients apart from their competitors in the marketplace. Our unique formula combines the expertise of our specialized physicians to create the leading cost containment and medical management solution in the nation, tackling the issues of medical cost and ensuring quality outcomes from a physicians perspective. This solution not only saves money, but also improves overall patient outcomes, providing the best of both - cost and care. inVentiv Medical Management clients include health plans, employer groups, third party administrators, MGUs and carriers. inVentiv Medical Management has saved its clients nearly $300 million.

Case Managers
The Case Manager will be responsible for assisting patients to achieve optimal health status utilizing the most cost effective quality resources through application of national practice guidelines and Case Management (CM) Standards of Practice. Case Managers will also be responsible for implementing appropriate interventions to manage multiple physical, psychological, social and financial barriers in cooperation with patient, insurance carrier, and medical provider. The ideal candidate will possess a minimum of a BSN, CCM, Active RN Licensure in state of practice and 3 years of Case Management experience in a managed care setting.

Utilization Review Nurse Auditors
The Nurse Auditors will be responsible for applying medical necessity guidelines based on appropriate criteria and maintain standards set for medical records review utilizing strong organizational, clinical and written communication skills. In this position you will be responsible for using these skills to read and audit your daily caseload of virtual charts, locate the key clinical indicators necessary to support your decision, then create a report in a provided template. The ideal candidate will possess a minimum of 3 years of Utilization Review experience, working knowledge of Milliman or Interqual criteria, 3 years clinical experience in the ICU, ER or med-surge and strong written communication skills.

Qualified candidates may email their resume to


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