HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

• Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time.  
• Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review.
  
• Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
  

• Must be an RN
• Inpatient HOSPITAL UR: Prior Auth, Concurrent Rev.  (6 months)- Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures
• NCQA experience ( at least one recent year)
• Interqual or Milliman (MCG) experience 
• Other basic computer skills necessary: Microsoft Office, Data Entry, etc. 
• Minimum 2-4 years of clinical practice.                    

Hours:

 Mon-Fri 8:30am-5pm

Advantages:

Competitive Pay ($33/hr. to $37/hr)

Benefits offered!

Great work environment!

Want to hear more information? 

Reach out to Jeff St Louis for immediate consideration by calling 407-478-0332 ext. 223!