Nurse Analyst - FWA - Baton Rouge, LA
Leverages patient care background and experience to support the healthcare business process services team in implementing company products and solutions to help providers improve healthcare delivery. Completes work with a limited degree of supervision. Demonstrates technical proficiency in a range of processes or procedures acquired through job-related training and on-the-job experience. May act as an informal resource for colleagues with less experience. Completes a variety of atypical technical tasks. Works within defined processes and procedures or methodologies and may help determine the appropriate approach for new assignments.
Overview:
- The Registered Nurse Analyst will work in the SURS department managing post payment review of Medicaid claims to identify fraud, waste or abuse.
Essential Job Functions
- Assists with gathering and/or validating patient data such as demographics, medication history and patient consent.
- Supports 24x7 patient care management services via patient outreach center leveraging telephone, text, or video communications. Manages required timekeeping processes and facilitates associated reporting.
- Implements comprehensive patient care plans, including guidance on establishing attainable treatment goals that are closely monitored to gauge progress.
- Ensures continuity of care with a practitioner or member of the care team. Provides follow-up services after a health event to ease patient transitions among healthcare providers and facilities.
- Provides process improvement suggestions to management to ensure maximum efficiency and effectiveness of company products and solutions.
Basic Qualifications
- Associates or Bachelor's degree in nursing
- Four or more years of experience as a registered nurse
- Experience working with medical procedures and techniques
- Coding and utilization review experience (Highly desirable)
Other Qualifications
- Good communication skills
- Good organization and time management skills
- Ability to work in a team environment
- Ability to keep sensitive and confidential material private
Work Environment
- Office environment
- 40 hour week in office with some opportunity for Work from home once established
Job Type: Full-time
Pay: From $1.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Ability to commute/relocate:
- Baton Rouge, LA 70802: Reliably commute or planning to relocate before starting work (Required)
Education:
Experience:
- Nursing: 4 years (Required)
Work Location:
Work Remotely:
- Temporarily due to COVID-19