OMS RN - PRIOR AUTHORIZATION

Description
Nurse care managers will develop and implement a targeted plan of care to decrease avoidable Emergency Department usage for MaineCare members. Partner with hospitals to provide ongoing education to members and provider community on selected members. Work
with the Care Management Unit staff members to monitor work queues and complete assigned tasks. Attend and participate in bi-weekly hospital rounds to discuss complex cases and determine appropriate outcomes. Collect data and prepare records, reports and statistical
information to assist in the evaluation and measurement of wellness programs and ED Care Management Initiative Project. Develop plans of care for clinically complex members. Attend conferences regularly for wellness initiatives available within the community.
Outreach members in the community via phone, mail, and fax. Perform other duties and responsibilities as may be assigned from time to time.
Requirements
Six (6) year combination of education, training, and/or experience. Must be a Licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the State of Maine and possess three (3) years of progressively responsible experience in the field of nursing
and/or in the delivery of health care services.

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