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Registered Nurse - Care Review Clinician Job

Eingestellt von Yoh

Gesuchte Skills: Cms, Client

Projektbeschreibung

REGISTERED NURSE CARE REVIEW CLINICIAN/PRIOR AUTHORIZATION needed for a Contract opportunity with Yoh's client located in Long Beach, CA.

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

  • Einsatzort:

    Long Beach, Vereinigte Staaten

  • Projektbeginn:

    asap

  • Projektdauer:

    Keine Angabe

  • Vertragsart:

    Contract

  • Berufserfahrung:

    Keine Angabe

Geforderte Qualifikationen

  • Kategorie:

    IT Entwicklung, Webentwicklung

  • Skills:

    cms, client

Yoh