State Licensed Inpatient RN Care Coordinator

Job Summary

A company is looking for a Care Coordinator - Inpatient RN.

Key Responsibilities

• Perform medical necessity reviews for inpatient and concurrent care requests, ensuring compliance with criteria and policies
• Consult with Medical Directors regarding cases that do not meet established criteria
• Document clinical information accurately and participate in quality improvement activities

Required Qualifications

• Bachelor's degree or four years of relevant work experience
• Current State Licensure as a registered nurse
• Three years of clinical experience
• Utilization Management experience (preferred)
• Experience in the health plan industry (preferred)