Pennsylvania Licensed RN Coordinator

Job Summary

To support a home health team, the part-time Pennsylvania Licensed RN Coordinator will evaluate members' clinical conditions, authorize medically necessary services, and interact with providers, working remotely for 18.75 hours per week with a flexible schedule.

Key Responsibilities

• Applies critical thinking and advanced medical knowledge to evaluate cases and make determinations on medical necessity
• Contacts providers to clarify treatment plans and ensure compliance with established criteria for services
• Collaborates with case management staff to facilitate appropriate discharge planning and identifies potential utilization issues

Required Qualifications

• Current Pennsylvania RN license or compact license including Pennsylvania
• Experience in care management or clinical evaluation
• Ability to work part-time, including a commitment to a flexible schedule with one shift on Friday
• Proficient in utilizing medical criteria and guidelines such as InterQual
• Must reside in Pennsylvania, New Jersey, or Delaware