RN / Public Programs' Specialist / Access Management Specialist

Compensation

: $108,945.00 - $101,600.00 /year *

Employment Type

: Full-Time

Industry

: Healthcare - Nursing



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RN / Senior Access Management Specialist Public Programs Direct Hire! Kelly Services has an exciting Direct Hire opportunity for a RN/Senior Access Management Specialist come work with our client located in Eagan, MN. This is an exciting opportunity to work for a very large insurance company assisting them with keeping the wheels of the health care industry turning. Apply today! Summary: The Access Management Specialist is a critical component of the Integrated Health Management team. The position exists to support the Public Programs Restricted Recipient Program via education, service coordination, and benefit management, monitoring and program referrals. The Access Management Specialist is a complex role with multiple challenges. Therefore, is a senior position and serves as a subject matter expert to team members. Accountabilities:

  1. Identifies individuals with high cost and complex health care utilization that may benefit from the Public Programs Restricted Recipient Program.
  2. Gathers accurate and comprehensive information from multiple sources; e.g. claims, pharmacy data and determines if usage is inappropriate.
  3. Identifies services needed by member and negotiates with member and provider for future, single point of service access.
  4. Educates members on the appropriate usage of health care services that maximize their outcomes and refers members to other programs as needed.
  5. Maintains outstanding level of service at all points of customer contact.
  6. Collaborates and coordinates with team members to facilitate day to day functions and enhance the overall operation of the department.
  7. Serves as a subject matter expert to team members.
  8. Mentors, coaches and fulfills role of preceptor on an ongoing basis.

Required Qualifications:

  • RN with MN license, with no restrictions
  • 5 years relevant clinical experience
  • 3 years of managed care experience; e.g. case management, utilization management
  • Outstanding communication skills, analytical thinking skills and task facilitation skills
  • Strong computer application skills
  • Medicare and/or Public Programs experience

Preferred Qualifications:

  • Outstanding telephonic skills
  • Mentoring experience
  • Process and project management experience

HOW TO APPLY: This position is recruited for by a remote Kelly office, not your local Kelly branch. To apply for this opportunity please utilize the Apply Now/Submit Resume button. You can also call Patti Vasseur at 919-###-####. Every day, Kelly Healthcare Resources (KHR) specializes in providing highly skilled nursing and allied health professionals within hospitals and other health care facilities, as well as positions in sectors such as insurance, pharmaceutical, health management and education.



Why Kelly?


As a worker today, it s up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find what s next is what we re all about. We know what s going on in the evolving world of work just ask the 440,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.




About Kelly


At Kelly, we re always thinking about what s next and advising job seekers on new ways of working to reach their full potential. In fact, we re a leading advocate for temporary/non-traditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.

Kelly is an equal opportunity employer committed to employing a diverse workforce and providing accommodations for people with disabilities in all parts of the hiring process as required under its Employment Accommodation Policy. Kelly will work with applicants to meet accommodation needs that are made known to Kelly in advance.



Job Requirements:

Associated topics: ambulatory, asn, bsn, cardiothoracic, care, maternal, psychatric, psychiatric, registed, unit * The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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