Care Coordinator UM/CM I - Work From Home (Healthcare)

Location: Remote from the United States; listed location is Albuquerque, New Mexico

Base pay: $61,500–$136,100 annually, plus eligibility for an annual incentive bonus.

Company

hirify.global provides health insurance and care services through a purpose-driven healthcare organization.

What you will do

• Perform concurrent reviews according to approved departmental guidelines.
• Plan discharges and identify alternate treatment programs.
• Conduct episodic case management for members.
• Assess, plan, and implement healthcare options and services within members’ benefit plans.
• Consult and collaborate with providers, members, and other appropriate resources.

Requirements

• Current, valid, unrestricted Registered Nurse license in the state of operations.
• Three years of clinical practice experience.
• Experience using various software packages.
• Strong verbal and written communication skills.
• Analytical skills.
• Additional applicable nursing licenses may be required for multi-state positions; license fees are provided.

Nice to have

• Familiarity with utilization management, case management, and standardized criteria sets.
• Knowledge of NFLOC and LTSS for New Mexico Medicaid.
• Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook.

Culture & Benefits

• Full-time employment with professional development plans.
• Health and wellness benefits, 401(k) savings plan, and pension plan.
• Paid time off, paid parental leave, paid holidays, and disability insurance.
• Supplemental life insurance, employee assistance program, and tuition reimbursement.
• Additional incentives may be available through the total rewards package.