Create Email Alert

ⓘ There was an unexpected error processing your request.

Please refresh the page and try again.

If the problem persists, please contact us with your issue.

Email address is already registered

You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.

Would you like to [visit your alert settings] now?

Success! You're now signed up for Job Alerts

Get ready to discover your next great opportunity.

Similar Jobs

  • Baylor Scott & White Health

    Wound Care RN_

    Irving

    **About Us** At Baylor Scott & White Health, we focus on promoting wellness for people, families, and communities. Baylor Scott and White is the biggest non-profit healthcare system in Texas that encourages healthy living. Our Core Values are: + We serve faithfully by doing what's right with a joyful heart. + We never settle by constantly striving

    Job Source: Baylor Scott & White Health
  • Baylor Scott & White Health

    Care Manager RN_

    Irving

    • Ending Soon

    **About Us** At Baylor Scott & White Health, we promote well-being for all. It's the largest healthcare system in Texas. It empowers you to live well. Our Core Values are: + We Serve faithfully by doing what's right with a joyful heart. + We never settle by constantly striving for better. + We are in it together by supporting one another and those

    Job Source: Baylor Scott & White Health
  • University of Texas Southwestern Medical Center

    RN Wound Care - Wound Care

    dallas

    RN Wound Care Registered Nurse Wound Care Why UT Southwestern? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees.

    Job Source: University of Texas Southwestern Medical Center
  • Gentiva

    Patient Care Manager, RN_

    Arlington

    **Our Company** Hospice Plus, part of the Gentiva family of hospice, home health, palliative, and community care providers, focuses on clinical excellence with compassion and dignity. Our company culture centers around humility, servant leadership, empathy, and innovation while we serve as a leader in the home care industry. Our people and our pati

    Job Source: Gentiva
  • University of Texas Southwestern Medical Center

    Registered Nurse Wound Care Clinic - Wound Care

    dallas

    Registered Nurse Wound Care Clinic Registered Nurse Wound Care Clinic Full Time Days Why UT Southwestern? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resour

    Job Source: University of Texas Southwestern Medical Center
  • University of Texas Southwestern Medical Center

    RN Wound Ostomy Care Clinic - Wound Care

    dallas

    RN Wound Ostomy Care Clinic Registered Nurse Wound Care Ostomy Clinic Full Time Days Why UT Southwestern? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resour

    Job Source: University of Texas Southwestern Medical Center
  • Baylor Scott & White Health

    Wound Care RN

    Irving, TX, United States

    About Us At Baylor Scott & White Health, we focus on promoting wellness for people, families, and communities. Baylor Scott and White is the biggest non-profit healthcare system in Texas that encourages healthy living. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for

    Job Source: Baylor Scott & White Health
  • Parkland Health and Hospital System (PHHS)

    Wound Care Technician - PRN-Comprehensive Wound Care Ctr

    Dallas, TX, United States

    • Ending Soon

    Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become pa

    Job Source: Parkland Health and Hospital System (PHHS)

Wound Care UM RN_

Grand Prairie

**Wound Care UM RN**

**Location:** Remote, within 50 miles of a pulse point

**Hours:** An 8 hour shift Monday - Friday between the hours of 8 am - 7 pm CST.

A proud member of the Elevance Health family of companies, Carelon Post Acute Solutions, formerly myNEXUS, is the leader in health resource optimization, focused on transforming how healthcare is delivered and promoting the advancement of care for the people we serve. The **Wound Care UM RN** is responsible for performing pre-certification certification and/or authorization activities for Home Health Services for members with wound care needs included as contracted services that meet eligibility and benefits coverage. You will oversee members who have complex wound needs to determine if the member has the appropriate wound care for the type of wound, and identify and monitor delivery of home-based services, respond to members total health needs and ensures the highest quality of continuity of care.

**How you will make an impact:**

+ Develops coordinated collaborative care plans with all involved providers.

+ Reviews Home based services for clinical appropriateness of the continued care.

+ Performs reviews telephonically using the members medical records discussion with the members physician and/or discussion with Home health agency staff.

+ Contacts the home care agency and ordering physician to discuss changing the member plan of care for wound care.

+ Promotes healing and decrease home care utilization.

+ Responsible for certification determinations and sending written authorizations to referring physician and home health care provider.

+ Requests additional clinical information from members care providers as necessary.

+ Facilitates timely discharges and transfers based on individual needs and care requirements.

+ Educates patients to help them understand their health choices and assists them in making informed decisions about their health care.

+ Serves as an information resource to patients health care professionals facilities health plan representatives care givers and family members.

+ Monitors cost-effective use of resources and uses clinical expertise to make recommendations for alternate resources as needed.

+ Refers requests that do not meet coverage guidelines criteria to Physician for review.

+ Uses clinical judgment in authorizations that fall outside of guideline parameters.

**Minimum Requirements:**

+ Requires RN license and minimum of 5 years of experience in a variety of health care settings; or any combination of education and experience which provides an equivalent background.

+ Current active unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States required.

+ Certifications relevant to wound care such as WOCN or CWS required.

**Preferred Skills, Capabilities and Experiences:**

+ Home health experience preferred.

+ 1 year of Utilization Management experience preferred.

+ Multi-State/Compact Nursing License strongly preferred.

** For candidates working in person or remotely in the **below** locations, the salary* range for this specific position is $34.54 to $62.17

Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Apply

Create Email Alert

Create Email Alert

Wound Care UM RN_ jobs in Grand Prairie

ⓘ There was an unexpected error processing your request.

Please refresh the page and try again.

If the problem persists, please contact us with your issue.

Email address is already registered

You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.

Would you like to [visit your alert settings] now?

Success! You're now signed up for Job Alerts

Get ready to discover your next great opportunity.