Fully Remote Clinical Review Nurse
Job Description
Job Description... A-Line is now hiring a Fully Remote Clinical Review Nurse in California (Must reside in state). This would be full time / 40+ hours per week. If you are interested in this Fully Remote Clinical Review Nurse position, please email Heather Foret [email protected], call Heather at 847-798-6487, or apply to this posting! Clinical Review Nurse Compensation The pay for this position is $40.00 per hour Benefits are available to full-time employees after 90 days of employment A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates Clinical Review Nurse Highlights Hours are Monday through Friday 8am 5pm PST Clinical Review Nurse Responsibilities Review concurrent and continued stay requests to ensure appropriate care and setting, following established guidelines and policies. Approve services or escalate requests to the Physician or Medical Director for secondary review. Complete medical necessity and level of care assessments for requested services using InterQual guidelines, referring to Medical Directors based on case findings. Collaborate with staff within provider networks and the discharge planning team, both electronically and telephonically, to coordinate member care. Conduct discharge planning activities to facilitate effective transitions of care. Educate providers on utilization and medical management processes. Provide clinical knowledge and serve as a resource to non-clinical team members. Enter and maintain relevant clinical information in various medical management systems. Clinical Review Nurse Requirements High School Diploma or GED 2-4 years of hospital, Managed care, or UM experience Graduate from an accredited School of Nursing California RN Microsoft experience and EMR experience If you think this Fully Remote Clinical Review Nurse is a good fit for you, please reach out to me by e-mail, or apply to this posting! Heather Foret Recruiting Assistant [email protected] Apply Job!