RN Case Manager / Concurrent Review

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

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