Seeking Registered Nurse

MASC Medical Recruitment Firm; Homestead (FL); On-site; USD 70,000 - 90,000; Full time

Job summary

MASC Medical Recruitment Firm is seeking a Case Manager (RN) in FL with 3+ years UR experience, including working knowledge of InterQual and Milliman criteria to determine admission status and medical necessity. FL RN license required. Prior discharge planning and coordination of post-discharge services are essential.

Responsibilities include psychosocial assessments and arranging durable medical equipment, home health care, SNF & ALF placements as part of safe transition planning.

Qualifications

• Current Florida RN license is required.
• Minimum 3 years of Utilization Review (UR) experience with InterQual and Milliman criteria.
• Experience communicating with external payers and determining medical necessity.

Responsibilities

• Discharge planning with psychosocial assessments.
• Coordinate safe transitions post-discharge (DME, home health, SNF/ALF).

Skills

UR (Utilization Review)

InterQual

Milliman Criteria

Admission decisions

Education

Florida RN license

Job description

Case Management (62870) Case Manager (RN) 3ryrs of UR exp including working knowledge of both InterQual & Milliman Criteria to determine admission status, medical necessity for continued stay and communication with external payers.

Discharge planning exp include psychosocial assessments and safe transition of pts post discharge include setting up durable medical supplies, home health care, SNF & ALF placement etc.

FL RN license

Additional Information

All your information will be kept confidential according to EEO guidelines.