Walker HealthForce

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Walker HealthForce jobs

Shift: 8:30am-5pm / Contract to Hire

JOB REQUIREMENTS
•        Clinical background
•        RN or LMSW with valid, unrestricted State of Michigan license
•        3-5 years of case management experience
•        Strong PC skills
•        Experience in discharge planning, home health care, rehabilitative medicine, community health and/or managed care
•        Knowledge of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles.
•        Knowledge of medical ethics and legal implications related to case management.
•        Understanding of social determinants of health and their impact on a patient’s wellbeing.
 
PREFERRED JOB REQUIREMENTS.
•        Bachelor's Degree

Detroit Michigan Walker HealthForce Job ID #32886.

**Candidates can live anywhere within the state of New York** Shift: M-F 8AM – 5PM EST

JOB REQUIREMENTS 
•        Associates Degree
•        Must type 100 words per minute
•        3 - 5 years of experience with a background in either of the following:
o        Utilization Management
o        Prior Authorization – Medical Surgical (Inpatient or Outpatient)
o        Complex Case Management w/ exposure to UM, Concurrent
o        Retrospective Medical Policy Review
•        Unrestricted Compact RN License
•        Proficient in UM policies and clinical guidelines
•        Proficient in Microsoft programs (Care Radius, Excel, OneNote, Outlook, Teams, Word, etc.)
 
PREFERRED JOB REQUIREMENTS
•        Bachelor's Degree
•        Utilization Review Certification
•        Health Insurance Payer experience
•        Familiarity interpreting Milliman Care Guidelines MCG guidelines
•        CareRadius platform exposure

Albany New York Walker HealthForce Job ID #532612.

**Candidates can live anywhere within the state of Pennsylvania** Shift: M-F 8AM – 5PM EST

JOB REQUIREMENTS 
•        Associates Degree
•        Must type 100 words per minute
•        3 - 5 years of experience with a background in either of the following:
o        Utilization Management
o        Prior Authorization – Medical Surgical (Inpatient or Outpatient)
o        Complex Case Management w/ exposure to UM, Concurrent
o        Retrospective Medical Policy Review
•        Unrestricted Compact RN License
•        Proficient in UM policies and clinical guidelines
•        Proficient in Microsoft programs (Care Radius, Excel, OneNote, Outlook, Teams, Word, etc.)
 
PREFERRED JOB REQUIREMENTS
•        Bachelor's Degree
•        Utilization Review Certification
•        Health Insurance Payer experience
•        Familiarity interpreting Milliman Care Guidelines MCG guidelines
•        CareRadius platform exposure

Harrisburg Pennsylvania Walker HealthForce Job ID #432612.

**Candidates can live anywhere within the state of Connecticut** Shift: M-F 8AM – 5PM EST

JOB REQUIREMENTS 
•        Associates Degree
•        Must type 100 words per minute
•        3 - 5 years of experience with a background in either of the following:
o        Utilization Management
o        Prior Authorization – Medical Surgical (Inpatient or Outpatient)
o        Complex Case Management w/ exposure to UM, Concurrent
o        Retrospective Medical Policy Review
•        Unrestricted Compact RN License
•        Proficient in UM policies and clinical guidelines
•        Proficient in Microsoft programs (Care Radius, Excel, OneNote, Outlook, Teams, Word, etc.)
 
PREFERRED JOB REQUIREMENTS
•        Bachelor's Degree
•        Utilization Review Certification
•        Health Insurance Payer experience
•        Familiarity interpreting Milliman Care Guidelines MCG guidelines
•        CareRadius platform exposure

Hartford Connecticut Walker HealthForce Job ID #332612.

**Candidates can live anywhere within the state of New Jersey** Shift: M-F 8AM – 5PM EST

JOB REQUIREMENTS 
•        Associates Degree
•        Must type 100 words per minute
•        3 - 5 years of experience with a background in either of the following:
o        Utilization Management
o        Prior Authorization – Medical Surgical (Inpatient or Outpatient)
o        Complex Case Management w/ exposure to UM, Concurrent
o        Retrospective Medical Policy Review
•        NJ RN or Compact RN License
•        Proficient in UM policies and clinical guidelines
•        Proficient in Microsoft programs (Care Radius, Excel, OneNote, Outlook, Teams, Word, etc.)
 
PREFERRED JOB REQUIREMENTS
•        Bachelor's Degree
•        Utilization Review Certification
•        Health Insurance Payer experience
•        Familiarity interpreting Milliman Care Guidelines MCG guidelines
•        CareRadius platform exposure

Trenton New Jersey Walker HealthForce Job ID #232612.

**Candidates can live anywhere within the state of Deleware** Shift: M-F 8AM – 5PM EST

JOB REQUIREMENTS 
•        Associates Degree
•        Must type 100 words per minute
•        3 - 5 years of experience with a background in either of the following:
o        Utilization Management
o        Prior Authorization – Medical Surgical (Inpatient or Outpatient)
o        Complex Case Management w/ exposure to UM, Concurrent
o        Retrospective Medical Policy Review
•        Unrestricted Compact RN License
•        Proficient in UM policies and clinical guidelines
•        Proficient in Microsoft programs (Care Radius, Excel, OneNote, Outlook, Teams, Word, etc.)
 
PREFERRED JOB REQUIREMENTS
•        Bachelor's Degree
•        Utilization Review Certification
•        Health Insurance Payer experience
•        Familiarity interpreting Milliman Care Guidelines MCG guidelines
•        CareRadius platform exposure

Dover Delaware Walker HealthForce Job ID #132612.

JOB REQUIREMENTS 
Registered Nurse (RN) with unrestricted license
Current Illinois driver's license
3 years of clinical experience
2 years of experience in utilization review, quality assurance, or statistical research
Clinical knowledge, knowledge of the UM/QR process, and knowledge of managed care principles
Able and willing to travel, including overnight stays
 
PREFERRED JOB REQUIREMENTS
Proficient in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.)

Chicago Illinois Walker HealthForce Job ID #29066.

Chicago Illinois Walker HealthForce Job ID #28708.

Shift: 8:30am-5pm 
JOB REQUIREMENTS 
• Master's Degree in social work, counseling or psychology
• Licensed Master’s Social Worker (LMSW); LLMSW

PREFERRED JOB REQUIREMENTS
• BLS (AHA)
• 3+ years social worker experience

Jackson Michigan Walker HealthForce Job ID #33113.

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