Job Description
We are aggressively seeking a RN Case Manager for a Healthcare organization. As the Year 2016 is in full swing, this organization is very busy, and they need YOUR help.
Take advantage of flexible hours,a competitive salary, and be a RN Case Manager with one of the fastest-growing healthcare companies in the U.S. Get in NOW, while there is still huge room for growth and career development!
This exciting opportunity will require a RN Case Manager who can provide a high level of service and attention to their members. If you are seasoned, and you meet the qualifications listed below, please send your updated resume to Alex Bennewitz for immediate consideration.
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
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
Qualifications
Requirements:
2 years RN experience in acute care with some utilization management, prior authorization, concurrent review, and proficient with Excel
Experience using TruCare system
Strong Excel experience background in diverse populations/environments (e.g. Critical care, ICU, cardiac, neonatal, pediatric, Case Management
Experience processing 10-15 authorizations a day
Additional Information
Interested in hearing more about this great opportunity? Please click Apply or call Alex Bennewitz at 513-996-1192
Company 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!