RN Team Coordinator - Clinical Review
7 days left
- Full Time
Optima Health is seeking a full-time Registered Nurse Team Coordinator for our Integrated Care Management Clinical DSU team in Virginia Beach, VA.
This role requires: responsibility, accountability and leadership for the daily operations including coordination of work, quality, and service. The clinical review team performs all post-service reviews, assists with updating and maintaining claims policies, assists BSI with claims processing, provides review for appeals, provides coding expertise to the entire organization. Assist with CCS policy changes and operationalizing changes as a result of coverage decisions.
BSN or MSN required.
Supervisory experience requited.
Minimum 3yrs of Case management experience required.
Assumes responsibility, accountability and leadership for the daily operations including coordination of work, quality, and service. First line supervisor in the Department of Medical Care Management for assigned site/function. Facilitates the work of assigned team members. Provides a leadership role in ongoing case manager competency assessment, needs identification and educational offerings. Provides educational services to the Medical Care Management staff . Participates in the work activities of assigned teams and provides case management services as needed.
RN-Bachelor's Level Degree
Required: Case Management - 3 years
Preferred: Supervisory - Previous experience
Required: Registered Nurse
Preferred: Basic Life Support
Required: Communication, Critical Thinking, Service Orientation
Preferred: None, unless noted in the “Other” section below
For Integrated Care Management departments, specialty certification required within one year of eligibility (ACM, CCM, CCCTM or RN-BC). For other service lines, certification based on specialty area required within one year of eligibility. BLS (if in a clinical setting).