Clinical - Clinical Review Nurse - Concurrent Review - J00933
Location: Remote (Must live in TX)
SHIFT: 10am-7pm CST, Schedule can be Sun-Thurs or Tues-Sat
Duration: 6 months possible extension or conversion
Requirements: RN TX license
- Typical Day in the Role: The RN will be reviewing about 20 cases a day to review for medical necessity on a member that admits to the hospital. Job is to advocate and protect the member from unnecessary admissions to the hospitals. Nurse has to follow many changes and processes to complete the authorizations. Will be working with a group of nurses to assist each other and collaborate on getting the cases done. The nurse will be in contact with doctors and case managers to achieve decisions and/or receive more information about the member s condition/status. Nurse will be using multiple resources we have to achieve successful completion of the cases.
- TX has doubled in enrollment this year so far. We are needing nurses who can cover late shift 10am-7 pm and weekends as that is our highest need right now.
Must haves: 2-4 years of hospital experience, multi tasking, time management, quick learner, go with the flow attitude, computer savvy
Nice to haves: UM, Clinical/managed care experience
Disqualifiers: unable to multi task, disorganized, not willing to make calls, not computer savvy
Performance indicators: Will be monitoring productivity daily
Candidate Requirements
Required: RN
Required: RN,
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