Concurrent Review

Immediate need for a talented Concurrent Review (RN). This is a 03+ months contract opportunity with long-term potential and is located in Redmond, WA(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-83912

Pay Range: $37 - $39/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• 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.
• Specific to the denial letters.
• No member or provider outreach

 
Key Requirements and Technology Experience:  

• Key skills; RN
• Concurrent review
• Denial letter
• 2 – 4 years of related experience. 2+ years of acute care experience required.
• Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred.
• Knowledge of Medicare and Medicaid regulations preferred.
• Knowledge of utilization management processes preferred
• RN - Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing 

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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