HEALTH CONSULTANT

PHRN - Pioneer PHRN Account - Libis Site

Job Description:

• Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function
• Gathers clinical information and applies the appropriate medical necessity criteria / guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care
• Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)
• Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment
• Identifies members who may benefit from care management programs and facilitates referral
• Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization

Benefits:

• 50K Recurring bonus
• Sponsored NCLEX Prep and Exam
• 50K Graduation bonus upon completion of NCLEX examination and acquiring of USRN License
• Better salary upon transfer to USRN team
• Free HMO Coverage from Day 1 for you and your Dependents!
• Structured Career path
• Temporary WFH

If you're interested you may apply using this link:

https://smrtr.io/bfK8S

Terms & Conditions Apply.