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Concurrent Review Nurse Job
Eingestellt von Yoh
Gesuchte Skills: Client
Projektbeschreibung
Top Skills You Should Possess:
- Utilization Review Experience
- Case Management Experience
- Registered Nurse
What You'll Be Doing:
- Responsible for concurrent and/or post service review of acute in-patient care services
- Participate in the utilization management transitions of care program to achieve goals of improved member outcomes
- Coordinate and facilitates a preauthorization review system for outpatient services to expedite hospital discharges
- Maintain documentation of clinical reviews in utilization management software system according to policy
- Review medical records to determine benefit coverage including appropriateness and level of care
- Other duties as assigned
What You Need to Bring to the Table:
- One (1) plus years of experience in utilization management, case management or equivalent
- Registered Nursing license in California
- Three (3) plus years of experience an acute care setting preferred
- Working knowledge of Title 22 regulations and Medi-Cal and related policies
- Working knowledge of Milliman Guidelines
- Advanced use of MS Office and Word
OPPORTUNITY IS CALLING, APPLY NOW!
RECRUITER: Emi Flaherty
Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Click here to contact us if you are an individual with a disability and require accommodation in the application process.
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Ref:
SFSF: REN
Projektdetails
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Einsatzort:
Merced, Vereinigte Staaten
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Projektbeginn:
asap
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Projektdauer:
Keine Angabe
- Vertragsart:
-
Berufserfahrung:
Keine Angabe
Geforderte Qualifikationen
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Kategorie:
IT Entwicklung