Care Review Clinician

This job has been removed
Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Fri, May 10, 2024
This job expires in: 11 days

Job Summary

A company is looking for a Care Review Clinician in Phoenix, AZ.

Key Responsibilities:
  • Conduct concurrent review and prior authorizations for MCO members
  • Identify benefits, eligibility, and expected length of stay for members
  • Collaborate with other departments to enhance continuity of care for members
Required Qualifications:
  • Completion of an accredited Registered Nursing program
  • Minimum 2-4 years of clinical practice in hospital nursing, utilization management, or case management
  • Experience with NCQA and knowledge of applicable state and federal regulations
  • Active, unrestricted State Nursing (RN, LVN, LPN) license in good standing
  • Proficiency in Interqual and other references for length of stay and medical necessity determinations

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