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As an integral part of the medical management model you will contribute to the optimization efforts of case management processes and play a vital role in maintaining the integrity of each client's healthcare plan. The company helps employers administer their own health plans.
* Provide ongoing member management, including making informed case determinations, assessment of ongoing treatment plans, and collaborating with member and provider teams to ensure maximum quality health outcomes
* Coordinate with providers, facilities, outpatient services, and other community resources to deliver exceptional client service, intervening as indicated to drive the appropriate delivery of care
* Proactively provide education and support to members related to their health care needs
* Identify and initiate negotiations for cost savings, quality care improvements, and benefit adjustments, as indicated, to ensure quality, cost-effective care across the healthcare continuum
* Play an integral collaborative role with Employer Groups, Account Managers, Stop Loss Carriers, and Claims Analysts
* Assist members in transitioning levels of care to ensure best delivery practices
* Evaluate outcomes and cost avoidance/ savings strategies and maintain rigorous valid data to ensure accurate client reporting
* Current WA State Registered Nurse clinical license or equivalent
* 3-5 years of clinical experience, preferably in the acute care setting
* Utilization Review/Management experience
* Strong experience in a clinical practice with diverse diagnoses
* Strong problem solving and critical thinking skills
* Knowledge of Case Management and Utilization Review processes preferred
* Excellent, client-facing verbal and written communication skills
* Behavioral health experience preferred
* Proficiency with Microsoft Office applications (Outlook and Word) and DOSS
* Motivated self-starter with the ability to work independently
* Enjoys the pace and rhythm of a deadline-oriented environment utilizing strong prioritization skills
*This position will be in-house for 1 month (training period) and then will be a flexible schedule/work from home option
We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.