RN Case Manager / Concurrent Review
Company Description
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!
Job Description
Review inpatient admissions to assure appropriate level of care and medical necessity for members.
100% Onsite/Telephonic
Review inpatient admissions to assure appropriate level of care and medical necessity
Review admissions through telephonic review to ensure medical necessity and appropriate level of care
Review and audit patient charts
Act as clinical resources to referral staff and make appropriate referrals
Provide patient and provider education
Data enters assessments, authorizations and reviews into the system
Qualifications
RN
2+ year’s clinical nursing experience.
At least 2 years of UM experience, with at least one year of CCR experience. (Chart Review, Discharge planning)
Plus to have CCR
Experience utilizing medical management software programs. Interqual/Miilman
UM certification preferred.
Managed Care preferred not required
Additional Information
Please apply to this job posting and attach a copy of your resume to be considered for this exciting opportunity. Contact Omar Cervantes at 407-478-0332 ext 129 to be considered