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Care Review Clinician
Location :
Remote
Job Type :
Contract
Reference Code :
15661
Hours :
Full Time
Required Years of Experience :
5-7 years of Clinical Experience
Required Education :
Bachelor Degree in Nursing
Travel :
No
Relocation :
No
Job Category :
Healthcare - RNs & Nurse Management
Job Description :
Our client, a major healthcare system, is seeking a Care Review Clinician to assist their Utilization Management team!
Shift: 8:30a-5p Mon-Fri
Care Review Clinician Job Responsibilities:
- Works with the UM team to review inpatient medical necessity while providing a high level of care.
- Provides daily review and evaluation of patients’ that require hospitalization and/or procedures.
- Completes prior authorizations and/or concurrent review.
- Completes assigned work plan objectives and projects on a timely basis.
Care Review Clinician Job Requirements:
- In depth knowledge of Interqual and other references for length of stay and medical necessity determinations.
- MUST have experience using MCG Criteria.
- Experience with NCQA
- Must have and active unrestrictive CA RN License
- 5-7 years of clinical practice in a hospital setting or utilization management/case management.
For immediate consideration, please email updated resume to jneary@mednationalstaffing.com.
Required Qualifications :
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