Care Review Clinician III Job

CARE REVIEW CLINICIAN needed for a CONTRACT opportunity with Yoh's client located in Long Beach, CA

THE BIG PICTURE - TOP SKILLS SHOULD YOU POSSESS:

- Prior Authorization Experience
- Utilization Review/Management Experience

WHAT YOU'LL BE DOING:

- Will work with the utilization management team responsible for inpatient medical necessity/utilization review
- Provide daily review and evaluation of members that require hospitalization and/or procedures
- Provides concurrent review and prior authorizations according to policies
- Identifies appropriate benefits, eligibility and expected length of stay
- Participates in interdisciplinary team meetings

WHAT YOU NEED TO BRING TO THE TABLE:

- RN or LVN license in the state of California (Active and in good standing)
- Graduate from an accredited school of Nursing
- Minimum of five to six years of clinical experience (5-6), preferably in hospital nursing
- Must have experience with NCQA, Utilization Management and/or Case Management
- Computer literate

OPPORTUNITY IS CALLING, APPLY NOW!

RECRUITER: Emi Flaherty

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Contact us if you are an individual with a disability and require accommodation in the application process.

J2W: HC

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SFSF: HC