Job Description

Performs clinical intake and reviews cases according to policies and procedures of HealthHelp Collects and enters confidential information ensuring the highest level of confidentiality in all areas Reviews clinical information against HealthHelp criteria and follows appropriate workflow Maintains written documentation according to HealthHelp's documentation policy Provides quality customer service through interaction with providers, administrative staff and others. Business focus demonstrates an understanding of the company’s vision, mission, and strategy Collaborates with client personnel to resolve customers concerns Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others Participates in the HealthHelp Quality Management Program as required Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs Adheres to both URAC & NCQA standards pertinent to their job description Collaborates with Human Resources to ensure adherence to company policies Performs other related duties and projects as assigned Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Qualifications

Graduate of an accredited school of nursing Current active unrestricted RN or LVN/LPN license in a state or territory of the U.S. Two years of prior experience in direct clinical care or managed care setting required Excellent interpersonal, written and presentation skills, including the ability to handle interactions with facility personnel, providers, members and various internal departments in a professional manner Ability to work in a fast-paced, evolving environment, on-call after hours work may be required Ability to utilize critical thinking skills Strong interpersonal and communication skills Highly motivated, self-starter who works independently using all available resources, policies, and procedures to work effectively and meet required timelines Knowledge of Microsoft Office and programs including Outlook, PowerPoint, Excel, and Word

Additional Information

All your information will be kept confidential according to EEO guidelines.