Clinical Review Nurse - Concurrent Review - J00933

Location : Remote-Texas; MUST have TX license, but compact license is okay but must be included in TX

SHIFT : 8AM-5PM CST Tuesday-Saturday

Duration : 6 months Contract to Hire

Position Purpose : Schedule will be 8am-5pm CST, Tuesday-Saturday. Will have task queue to work from. Will work closely with team lead and team members to meet daily deadlines. Will be reviewing cases for medical necessity all day. Will work from home with multiple monitors and needs to be able to multitask. 15 reviews / day.

• This is a fast-paced role. The nurse will be reviewing clinical faxed in by facilities for medical necessity. Client is a close-knit team with a positive work environment.

Description : Job Profile Summary : Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member.

Must haves : Multitasking, fast learner, positive, and be computer savvy.

Nice to haves : Flexibility, Post-Acute and / or NICU experience preferred, Not required

Disqualifiers : Less than 2 years of nursing experience, no LPNs

Performance indicators : Quality work and meet productivity expectations

Candidate Requirements Education / Certification Required : Graduate from an Accredited School of Nursing or bachelors degree in nursing - 2-4 years of related experience (clinical exp as a Nurse) Preferred : 2-4 years of related experience Licensure Required : Texas RN Preferred : Post-Acute and / or NICU experience