Concurrent Review RN

Healthcare Support Staffing; Tacoma (WA); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Competitive salary, negotiable based on experience

Medical, Dental, and Vision benefits

Fun and positive work environment

Job summary

A national healthcare staffing firm is seeking an experienced RN for a clinical role in Tacoma, WA. This position involves reviewing care requests and coordinating member care with a focus on discharge planning. Candidates should have at least 2 years of inpatient hospital experience, preferably in MED-SURG, and hold an RN license. The company offers competitive salary and a positive work environment with benefits including medical, dental, and vision.

Qualifications

• Must hold an RN license and have an Associate's degree in Nursing.
• Minimum of 2 years of inpatient hospital experience, preferably in MED-SURG.
• Experience with discharge planning processes is essential.
• Familiar with InterQual or Milliman guidelines.

Responsibilities

• Perform onsite reviews of care requests and approve or forward for further review.
• Educate providers about utilization and medical management processes.
• Collaborate with staff to coordinate member care.
• Educate providers on utilization and medical management processes.
• Act as a clinical resource to non-clinical staff.

Skills

Discharge planning experience

Inpatient hospital experience

Computer skills

Clinical knowledge

Education

RN license

Associate's degree in Nursing

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Daily Responsibilities:

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

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

Qualifications

Requirements:

RN license & associate’s degree in Nursing

Must have discharge planning experience

Must have inpatient hospital experience (MED-SURG is ideal) –at leastabout 2 years

Computer skills! Must be comfortable &able to learncomputer systems

Preferably have:

Interqual or Milliman experience

Hours for this Position:

Flexible - roughly 8:00-5:00 or 8:30 to 5:00

Advantages of this Opportunity:

Competitive salary, negotiable based on relevant experience

Benefits offered, Medical, Dental, and Vision

Fun and positive work environment

Additional Information

Want More Information?

• If you are interested in applying to this position, please contact Ashley Greene @ 407-478-0332 ext 169 or email and click the Green "I’m Interested" Button to email your resume.