Forwarding requests to the appropriate physician or medical director with recommendations for other determinations. Qualifications for this position include: Candidates must be licensed RN in Georgia, and live in the greater Atlanta metro area.
Attends physician/ hospital appointments. Reliable transportation and local travel required. Must be a Registered Nurse with current unrestricted CA RN license. 3 to 5 years clinical nursing experience. Strong technology, organizational and documentation skills are a must.
Supporting physician decision-making. Position Requirements Include: Bachelor’s degree in a relevant field, or an equivalent combination of education and highly relevant experience. Current, unrestricted license as an LPN or RN. Previous experience in Managed Care, Utilization Management.
A revenue management company has an open position for a Telecommute Physician Advisory Services Utilization Review Specialist. Individual must be able to fulfill the following responsibilities: Performing initial admission and continued stay reviews.
An insurance company is in need of a Telecommute Long Term Care Nurse Practitioner Physician Assistant in the Milwaukee Area. Core Responsibilities of this position include: Collaborating with primary care physicians, facility staff and patients' families.
Assessing the participant, and working with the participant, family and physician to identify problems. Providing utilization review/pre-certification or pre-notifications on various individuals. Assessing and documenting clinical and behavioral outcomes.
Participating in telephonic discussions with emergency department physicians. Reviewing electronic medical records of emergency department admissions. Entering clinical review information into system for transmission to insurance companies. Required Skills:
Discussing the financial aspect of specialty drugs with both the member and the ordering physician. Coordinating concomitant services to support infusion administration in lower cost sites. Providing member with resources to optimize their treatment outcomes. Position Requirements Include:
Working closely with the patient, caregiver, physician, RN care coordinator, care team, and acute care facilities to ensure the patient's individual needs are met. Applicants must meet the following qualifications:
Representing the company before client management, members, and physicians. Required Skills: Ability to travel occasionally as needed including overnight stays. Ability and willingness to provide coverage after hours on a call rotation.