Top 11 Utilization management nurse Jobs in Springfield, Vt

Clinical Reimbursement Coordinator
Elm Wood Center —Claremont, NH
- $45 - $47 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
- Disability insurance
- Dental insurance
3d
Supervisor Licensed Practice Nurse ( LPN) - Family Medicine, Newport
Dartmouth-Hitchcock —Newport, NH
- $65,436.80 - $101,441.60 a year
- Full-time
- Nursing
- BLS Certification
- Mid-level
- Disability insurance
- Health insurance

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Clinical Supervisor – Child & Family Services (Lebanon)
West Central Behavioral Hea —Lebanon, NH
NH State Loan Repayment Program – NH professional license required. Master's Degree in Social Work, Clinical Mental Health Counseling, or equivalent field.
$68,500.00 - $104,483.09 a year
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Rheumatologist
HCP Talent —Rutland, VT
Licensure: Active, unrestricted license to practice medicine in the State of Vermont (or immediate eligibility to obtain licensure prior to start date).
$295,000 - $365,000 a year
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12d

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Utilization Management Behavioral Health Professional
Humana —Ohio
Bachelor's degree in nursing OR a master's degree in a Human Services field with a professional individual or compact licensure in the state of Kentucky without…
$65,000 - $88,600 a year
1d
Nurse - Skilled/Purchased Care Coordinator
US Veterans Health Administration —Columbus, OH
Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the…
$70,726 - $148,921 a year
8d

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Clinical Reimbursement Coordinator

Elm Wood Center -
Claremont, NH

Apply Now

Job Details

Full-time
$45 - $47 an hour
3 days ago

Benefits

Disability insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Opportunities for advancement
Life insurance
Pet insurance

Qualifications

RN License
Long-term care facility experience

Full Job Description

Overview:

Elm Wood Center is Hiring a Clinical Reimbursement Coordinator (MDS)

Come join our amazing team!

Under New Leadership

At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Whether you're an experienced professional or just starting your career, we offer opportunities for growth, development, and advancement in a range of roles. Join us in our mission to enhance the well-being of our patients and residents while making a meaningful impact in the communities we serve.

Responsibilities:

The MDS Nurse - RN manages the overall process and tracking of all Medicare/Medicaid case-mix documents to ensure appropriate reimbursement for all services provided within the nursing.

Maintain an accurate schedule of all MDS assessments to include the proper reference dates throughout the patient stay and ensures the accurate and timely submission of the MDS assessments including case-mix, OBRA and OSRA required assessments.
Perform concurrent MDS review to insure appropriate RUGs category is achieved through the capture of appropriate clinical information and in this process identify opportunities to enhance reimbursement.
Communicate case-mix data required for billing to the Business Office such as RUGs categories, modifiers, state case-mix scores, etc.
Serve as the nursing center resource for MDS/RUGs and state case-mix systems providing staff case-mix education and instruction on MDS terminology and format.

Qualifications:

Must be a graduate of an accredited School of Nursing with current RN licensure in the state in which employment occurs is required.
One year of long term care clinical nursing experience is required.
Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable.
Must maintain current BLS/CPR certification (excluding ALFs/ILFs).

Benefits:

Variable compensation plans
Tuition, Travel, and Wireless Service Discounts
Employee Assistance Program to support mental health
Employee Foundation to financially assist through unforeseen hardships
Health, Dental, Vision, Company-paid life insurance, 401K, Paid Time Off
Free 24/7 virtual health care provided by licensed doctors for all Anthem medically-enrolled employees and their immediate family members
On-Demand Pay Program that allows for instant access to a portion of the money you’ve already earned

We also offer several voluntary insurances such as:

Pet Insurance
Term and Whole Life Insurance
Short-term Disability
Hospital Indemnity
Personal Accident
Critical Illness
Cancer Coverage

Restrictions apply based on collective bargaining agreements, applicable state law and factors such as pay classification, job grade, location, and length of service.

Posted Salary Range: USD $45.00 - USD $47.00 /Hr.

Apply Now

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utilization management nurse jobs in springfield, vt

Clinical Reimbursement Coordinator

Supervisor Licensed Practice Nurse ( LPN) - Family Medicine, Newport

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