Experience: 3 years of experience in one or a combination of the following: Specialty nursing (which may include NICU, PICU, CICU, Cardiology, Endocrinology et.), case management, care coordination, utilization review, patient intake, discharge planning and troubleshooting fund resources, quality assurance, clinical pathways, continuous quality improvement, or state and federal health plans or commercial insurance plans in a clinical or managed care environment. The goal is to promote optimal patient outcomes, prevent unnecessary hospital readmissions, and ensure that resources are utilized effectively while advocating for the patient's specific health goals.