RN Clinician Cover Letter

I submit this application to express my sincere interest in the RN clinician position.

Previously, I was responsible for services and documentation in accordance with Medicaid billing and agency standards including communication with Medicaid billing authorities and other licensed practitioners involved in service delivery/treatment coordination.

Please consider my experience and qualifications for this position:

• Out-patient Rehabilitation/Physical Medicine clinical experience
• Experience with pelvic floor muscle rehabilitation including urodynamic bladder evaluation, biofeedback and incontinence management
• CRRN credential
• Advanced Clinician experience
• Experience with billing management
• Experience with MediServe and Cerner electronic medical record applications
• Able to demonstrate professional skills, departmental competencies necessary to be a practitioner/consultant/mentor
• NIHSS Certification (Prior to Start Date)

I am excited to be applying for the position of RN clinician. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for consultation to health care providers and others to influence care plans, enhance ability to provide health care and affect change.

Please consider my qualifications and experience:

• Maintains professional growth and development through self-directed learning activities and/or involvement in professional, civic, and community organizations
• Ongoing interactions as needed with the care management team to ensure, as applicable, efficient and safe care transitions and changes in member status, and or additional information needed to make a determination
• Works with external providers to obtain clinical information necessary to complete the review
• Adheres to all regulatory and contractual requirements related to the UM function
• Health Plan experience performing utilization review activities
• Experience with McKesson's InterQual Clinical Screening Criteria desirable
• Clinical experience in area of credential
• Results orientation - strives to meet business goals

I am excited to be applying for the position of RN clinician. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for support to other staff with issues related to Medicaid and other managed care plans, Agency of Persons with Disabilities, Home Health Agencies and durable medical equipment companies.

My experience is an excellent fit for the list of requirements in this job:

• Excellent communication skills, project development and critical thinking skills
• Excellent project development skill
• Demonstrates critical thinkin skills
• Demonstrates professional skills and departmental competencies necessary in a practitioner/consultant/mentor role
• Neuro recent experience
• Active, unrestricted Registered Nursing license in the state of employment
• Adherence to established medical and administrative review guidelines and criteria
• Adherence to timelines associated with organizational determinations and notifications

I submit this application to express my sincere interest in the RN clinician position.

In the previous role, I was responsible for education throughout the continuum of care to patients, families, staff members and physicians as needed, including care for cancer-related pain, chemotherapy education, palliative care and hospice services.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Daily interactions with UM Support staff and providers to ensure clinical data is available and applicable to the review process
• Daily review of the pending list to ensure prioritization of authorization requests
• Reviews all prior authorization requests including but not limited to inpatient, admissions, specialty referrals, outpatient procedures and specific ancillary services such as, home health, DME, VNA or outpatient therapies as specified in the prior authorization list using CMS and InterQual licensed clinical criteria sets specified
• Performs concurrent reviews related to acute admissions and SNF, and real time telephone reviews for Medical services
• Identifies and determines benefit coverage for medical requests
• Identifies and determines medical necessity of out of network requests for services
• Redirects members and providers to in network or in network preferred provider
• Communicates effectively with the Medical Director regarding identified variances for specific members according to criteria utilized for medical review

I am excited to be applying for the position of RN clinician. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for information for field charts for each discipline with medical record information for hospice standards of care.

My experience is an excellent fit for the list of requirements in this job:

• Medical knowledge of Medicare and/or Public Programs
• Demonstrated knowledge of complaints, appeals and grievance regulations and understanding of a variety of health plan products
• Current certification (Certification of Ambulatory Care Nursing) from a formally recognized professional association
• Graduate of California BRN-approved or regionally accredited nursing program
• Current Certified Hospice and Palliative Nurse (CHPN) certification
• CPR and ACLS certifications
• Critical Care and Cath Lab experience
• Basic keyboarding, database and office navigation skills