[Remote/WFM] Fully Remote Clinical Review Nurse

Core Information:

• Company: Workwarp
• Compensation: a competitive salary
• Position: Fully Remote Clinical Review Nurse
• Start Date: Immediate openings available
• Location: Remote

 

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Job Description Job Description... A-Line is now hiring a Fully Remote Clinical Review Nurse in California (Must reside in state). This would be full time / 40+ hours per week. If you are interested in this Fully Remote Clinical Review Nurse position, please email Heather Foret [email protected], call Heather at 847-798-6487, or apply to this posting! Clinical Review Nurse Compensation • The pay for this position is $40.00 per hour • Benefits are available to full-time employees after 90 days of employment • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates Clinical Review Nurse Highlights • Hours are Monday through Friday 8am – 5pm PST Clinical Review Nurse Responsibilities • Review concurrent and continued stay requests to ensure appropriate care and setting, following established guidelines and policies. • Approve services or escalate requests to the Physician or Medical Director for secondary review. • Complete medical necessity and level of care assessments for requested services using InterQual guidelines, referring to Medical Directors based on case findings. • Collaborate with staff within provider networks and the discharge planning team, both electronically and telephonically, to coordinate member care. • Conduct discharge planning activities to facilitate effective transitions of care. • Educate providers on utilization and medical management processes. • Provide clinical knowledge and serve as a resource to non-clinical team members. • Enter and maintain relevant clinical information in various medical management systems. Clinical Review Nurse Requirements • High School Diploma or GED • 2-4 years of hospital, Managed care, or UM experience • Graduate from an accredited School of Nursing – California RN • Microsoft experience and EMR experience If you think this Fully Remote Clinical Review Nurse is a good fit for you, please reach out to me by e-mail, or apply to this posting! Heather Foret – Recruiting Assistant [email protected] Apply Job!

 

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