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Registered Nurse - Care Review Clinician Job
Eingestellt von Yoh
Gesuchte Skills: Cms, Client
Projektbeschreibung
THE BIG PICTURE - TOP SKILLS YOU SHOULD POSSESS:
- Registered Nurse License in State of CA
- Prior Authorization Experience
- 40-50 Cases Per Day
- Must have Utilization Review Experience in a Managed Care Setting
WHAT YOU'LL BE DOING:
- Provide daily review and evaluation of members that require hospitalization
- Provide concurrent review and prior authorizations to Utilization Management Department
- Identify appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures
WHAT YOU NEED TO BRING TO THE TABLE:
- Registered Nurse Licensure in State of CA (Active and in Good Standing)
- At Least three (3) years of clinical experience
- At least three to five (3 - 5) years of Utilization Review experience in a Managed Care Setting
- Three to five (3 - 5) years of Concurrent Review and Prior Authorization Experience
- Must be able to Process 40-50 Cases per day
- Experienced in Length of Stay
- Must have Experience with Inter-Qual and CMS guidelines
- Knowledge of applicable state, and federal regulations
- Must have NCQA Experience
- Excellent verbal and written communication skills
- Proficient in Microsoft Office: Word and Excel
OPPORTUNITY IS CALLING, APPLY NOW!
RECRUITER: Christine Mosessian
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.
J2W: HC
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Ref:
SFSF: HC
Projektdetails
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Einsatzort:
Long Beach, Vereinigte Staaten
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Projektbeginn:
asap
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Projektdauer:
Keine Angabe
- Vertragsart:
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Berufserfahrung:
Keine Angabe
Geforderte Qualifikationen
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Kategorie:
IT Entwicklung, Webentwicklung