Home Health Care Coordinator - EviCore - Work at Home

The Registered Nurse will perform medical necessity reviews for Initial and Concurrent authorization requests for Home Health services. Responsibilities include but are not limited to:

• Medical Necessity Review for Initial and Concurrent Review authorization requests.
• Development, evaluation and coordination of an individualized plan of care for each patient.
• Monitor progress toward desired care outcomes; review the care plan in conjunction with the direct care providers.
• Facilitate a timely and safe discharge.

Minimum Education and Licensure Requirement:

• Current unrestricted Registered Nurse licensure.
• Associate degree or Bachelor Degree in Nursing preferred.
• Multistate license preferred. Must hold license in state of residence.

Minimum Experience required

• Minimum 2 years clinical experience.
• Acute care, Home Health, SNF and/or Rehab experience desired.
• Medicare/Medicaid managed care knowledge preferred.
• The position is telephonic/Work at Home.
• Hours: Monday - Friday; 8a-5p in current time zone; Position is full-time during core business hours with the ability to work any shift between 7 am and 7 pm CST.
• Availability for weekend rotation, on-call rotation, and holiday rotation required.
• The ability to sit at a desk 50% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standing.
• Ability to perform dependable and reliable work schedule is essential.

Required Skills:

• Time-management: Ability to effectively manage one's time and resources to ensure that work is completed efficiently Excellent organizational skills.
• Communication: Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership.
• Critical-Thinking/Decision-making: Ability to choose a course of action or developing appropriate solutions by identifying and understanding issues, problems, and opportunities.
• Autonomy: Ability to work independently with little to no supervision.
• Proficient in computer literacy skills with ability to use and troubleshoot Microsoft Word, Excel, Outlook, and PowerPoint with the ability to type 30 wpm preferred.
• Experience using videoconferencing systems such as WebEx.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 30 - 50 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Apply tot his job Apply To this Job