IVF Care Manager (RN)

The Execu|Search Group
Aug 13, 2017
Aug 14, 2017
Employer Type
Direct Employer
Employment Type
Full Time
Job Description:

About the Opportunity A healthcare company in Westchester County is actively seeking a licensed Registered Nurse (RN), with a strong IVF background, for a promising Care Manager position with their growing staff. Under the guidance of the Vice President of Clinical Services and Consulting Chief Medical Officer, the IVF Care Manager (RN) will be responsible for managing treatment plan utilization and care, reviewing clinical outcomes to determine appropriateness of care, and ensuring the company and contract obligations are met. Apply today! Company Description Healthcare Company Job Description The IVF Care Manager (RN) will: * Review medical treatments and approves care based on the company's medical and contract guidelines * Review non-standard service outcomes and enter outcomes into the Authorization Tracking System (ATS) ensuring entry of all required information * Review data entered into ATS by Customer Service Agents (CSA) to ensure accuracy and completeness * Call patients to discuss care, clarify, augment and/or confirm accuracy of information received from providers to ensure appropriate care, as necessary * Ensure providers are informed of patient needs, treatment modification, and/or progress, when necessary or requested * Handle complex clinical issues or questions and troubleshoot clinical problems for the CSA team * Track ART trends, quality of care, protocols and pathways, denial and appeal service reviews, and state mandates to ensure the company's protocols are continually improving to meet or exceed ASRM guidelines * Utilize knowledge of ATS, contract obligations, infertility, and best business practices to provide superior service to clients * Review benefit status based on customer plans and eligibility file information prior to authorization of services or administrative / benefit denials Required Skills * 2+ years of experience in Assisted Reproductive Technology, including General Infertility; IVF or Infertility Care Management; or, Women's Health * Associate's Degree in Nursing * NYS Registered Nurse (RN) license * Microsoft Office/Suite proficient * Solid assessment, clinical, and documentation skills * Patient oriented * Great interpersonal skills * Excellent communication skills (written and verbal) * Strong attention to detail * Highly organized * Able to multitask efficiently and effectively Desired Skills * Bachelor's Degree in Nursing * Bilingual (English and Spanish)