Talentify
REMOTE Utilization Review RN - CA License - PST
This job is now closed
Job Description
- Req#: JP-004318088
Employer Industry: Healthcare Services
Why Consider this Job Opportunity:
- Salary up to $CompetitivePay
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and outcomes
- Work remotely anywhere within the continental U.S.
What to Expect (Job Responsibilities):
- Coordinate continuing care/outside services for value-based risk members
- Monitor patients in Skilled Nursing Facilities and out-of-network admissions
- Screen for appropriateness of care and establish stability for transfer
- Coordinate post-hospitalization treatment plans and evaluate effectiveness
- Assist in overseeing the discharge process for a select group of patients
What is Required (Qualifications):
- California RN License
- BLS AHA certification
- 5+ years of clinical experience
- 3-5 years of Utilization Management experience
- 1-3 years of recent care management prior authorization experience
How to Stand Out (Preferred Qualifications):
- Working knowledge of InterQual
- Experience with health plan auditors
- Knowledgeable of NCQA and ICE standards
#HealthcareServices #UtilizationReview #CareManagement #CareerOpportunity #RemoteWork
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