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TRICARE Coordinating Nurse – Puerto Rico

Job Order ID 3436
Country United States
Province/State Puerto Rico
City San Juan

Posted Date 11/6/2019

Brief Description

Executive Alliance is seeking a Registered Nurse for a client in San Juan, Puerto Rico to join a global healthcare organization. The position is full-time and the client is looking to hold on-site interviews on November 18, 2019, in San Juan, Puerto Rico.

Registered Nurse responsibilities include:

Delivery of professional and effective medical assistance services for TRICARE beneficiaries in compliance with TRICARE guidelines and TOP Contract specifications and expectations, and maintaining the highest standards of excellence.

Responsibility for medical due diligence and case direction with respect to designated medical assistance cases on all TRICARE transmissions.
Responsibility for designated medically related tasks on all medical assistance cases and on all TRICARE transmissions.
Assessment of each designated case with respect to its medical elements and provide direction in order to facilitate medical due diligence and render the appropriate assistance.
Provision of assistance with referrals and retrospective claims assessments as may be requested.
Responsibility for ensuring that there is an appropriate medical handover of cases at the beginning/ end of each shift.
Provide medically-driven case direction during the daily morning transmission process.
Determine the frequency/intensity of medical contacts and communication with Treating Doctors, patients, family members and associated TRICARE personnel.
Assist with any referral and monitor the progress of medical hospitalization cases.
Provide medical input toward the planning and progress of operational issues relating to medical case management.
Company benefits and their investment in you:
Keen to promote a work/life balance
Competitive salary
Flexible working hours
Generous paid time off
Tuition reimbursement
Continuing Nurse Education (CNE) Days
Opportunities for International travel
An opportunity to work in a positive working environment with enthusiastic colleagues

Requirement Note

United States citizenship
Registered Nurse licensure (current)
BCLS certification (current)
ACLS certification (current)
Three to five years of recent inpatient clinical experience
ICU and emergency medicine experience is preferred
Proficiency in Word Documents, typing, communication skills
Bilingual in English and Spanish
Opportunities for travel are available and optional

Contact Details:
Ruchi Virmani
(813) 973-2200 ext. 3004