Concurrent Review RN

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POST DATE 8/30/2016
END DATE 11/24/2016

ALL's WELL Orlando, FL

Company
ALL's WELL
Job Classification
Full Time
Company Ref #
23105177.21602206
AJE Ref #
576021252
Location
Orlando, FL
Job Type
Regular
Required Licenses/Certifications
df-aj

JOB DESCRIPTION

APPLY
Direct Hire/Permanent
Location-Maitland, FL
Salary-$65,000
Monday-Friday 8a-5p

Job description

Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews.

?? Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations

? Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings

? Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member care

? Conduct discharge planning

? Educate providers on utilization and medical management processes

? Provide clinical knowledge and act as a clinical resource to non-clinical team staff

? Enter and maintain pertinent clinical information in various medical management systems


Qualifications:

Education/Experience: Associate?s degree in Nursing. Bachelor?s degree in Nursing preferred. 2+ years of clinical nursing experience in an acute care setting. Knowledge of healthcare and managed care preferred.


Licenses/Certifications: Current state?s RN license.



This position will be housed in our Maitland office full time.
We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.

Job Experience:

Education/Experience: Associate?s degree in Nursing. Bachelor?s degree in Nursing preferred. 2+ years of clinical nursing experience in an acute care setting. Knowledge of healthcare and managed care preferred.


Licenses/Certifications: Current stat