Registered Nurse

Are you an experienced Registered Nurse looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Position Purpose:

Registered Nurse will promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews.

Daily Responsibilities:

• Registered Nurse will be reviewing charts through faxes or EMR and determining plans of action. They will apply their clinical knowledge to determine the appropriate measures are being taken to keep members out of the hospital. No travel involved!!

• Registered Nurse will 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

• Registered Nurse will 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

• Direct care to participating network providers

• Participate in utilization management committees and work on special projects related to utilization management as needed

Requirements:

• Valid RN License required

• 3+ years of clinical nursing experience in acute care setting

• Good tenure

• Positive Attitude

Hours for this Position: Monday – Friday 8:00 am - 5:00 pm

Advantages of this Opportunity:

• Competitive salary

• Annual Bonus

• Medical benefits go into effect 30 days after start date

Want More Information?

For immediate consideration, please click Apply Now or email your resume to Shanna Ramirez directly.