Concurrent Review RN

Immediate need for a talented Concurrent Review RN. This is a 06 Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-32985

Pay Range: $37 - $40.5/hour. Employee benefits include but are not limited to health insurance (medical dental vision) 401(k) plan and paid sick leave (depending on work location).

Key Responsibilities:

• Conduct concurrent reviews to determine the appropriateness of care and setting for members.
• Review quality and continuity of care by analyzing acuity levels resource consumption length of stay and discharge planning.
• Collaborate with Medical Affairs and Medical Directors to discuss member care.
• Document and maintain concurrent review findings and discharge plans in health management systems.
• Work with healthcare providers to approve medical determinations based on concurrent review findings.
• Educate providers on utilization processes to promote high-quality care.
• Provide feedback to leadership on opportunities for improvement in care levels and medical necessity.
• Ensure timely discharges by reviewing transfer or discharge plans.
• Collaborate with care management for appropriate member referrals.
• Apply clinical acumen to enhance the quality and cost-effectiveness of medical care.
• Perform other duties as assigned.

Key Requirements and Technology Experience:

• 2 years of acute care experience required.
• Graduate from an Accredited School of Nursing.
• Nursing License with state of Georgia or Compact licensure.
• Experience in Concurrent Review Utilization Management within a Medicaid/Marketplace health plan.
• Proficiency with Interqual and electronic medical records.
• Strong computer skills (Word Excel).
• Excellent written and verbal communication skills.
• Additional experience in healthcare and managed care.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position please apply online for immediate consideration.

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