Concurrent Review Nurse I
Company: Centene Coproration
Location: Little Rock
Posted on: February 15, 2020
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Job Description:
Description: Position Purpose: Perform onsite review of
emergent/urgent and continued stay requests for appropriate care
and setting, following guidelines and policies, and approve
services or forward requests to the appropriate Physician or
Medical Director with recommendations for other determinations
Complete medical necessity and level of care reviews for requested
services using clinical judgment and refer to Medical Directors for
review depending on case findings Collaborate with various staff
within provider networks and discharge planning team
electronically, telephonically, or onsite to coordinate member care
Conduct discharge planning Educate providers on utilization and
medical management processes Provide clinical knowledge and act as
a clinical resource to non-clinical team staff Enter and maintain
pertinent clinical information in various medical management
systems For New Hampshire and Massachusetts - home visits
required
Keywords: Centene Coproration, Little Rock , Concurrent Review Nurse I, Healthcare , Little Rock, Arkansas
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