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Wound Care UM RN
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Full-time
- Job Description :Wound Care UM RN Location: Remote, within 50 miles of a pulse pointHours: 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.
- Reviews Home based services for clinical appropriateness of the continued care.
- Contacts the home care agency and ordering physician to discuss changing the member plan of care for wound care.
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