RN Case Manager / Concurrent Review

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

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

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