Contract Analyst - GHP Provider Network Management - Danville

Work Hours: full-time - 1st shift

Category: Nursing / Certified Clinical

JOB SUMMARY:
Responsible for assessment and management of Health Plan Members admitted to acute and subacute care facilities, with the objective of ensuring delivery of comprehensive, cost-effective, quality care, as well as appropriate allocation of medical resources. Reports through the Utilization Management (UM) Nurse Manager to the Director of UM, and receives direction from the Health Plan Medical Director.

Demonstrates strong clinical assessment skills and excellent communication, organization and time management skills required. Demonstrated customer focused interpersonal skills to interact in an effective manner with physicians, the interdisciplinary health care team, community agencies, Members and families required. Demonstrates the ability to function independently and effectively in a rapidly changing environment, as well as the ability to influence and negotiate individual and group decision-making processes. Demonstrates general computer knowledge, with proven keyboarding proficiency.

Registered Nurse with current Pennsylvania license required. Minimum of five years acute care nursing experience, with no less than 2 years in an acute care hospital setting, to include intensive, critical care or Emergency Department experience required,and preferably a combination of adult and pediatric experience.Case management or Utilization Management experience preferred, as is knowledge of basic concepts and principles of managed care.
REQUIREMENTS
Please see Job Description