CaryRecruiter Since 2001
the smart solution for Cary jobs

Concurrent Review Nurse I (Durham County)

Company: Carolina Complete Health
Location: Morrisville
Posted on: April 4, 2021

Job 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 systemsPromote 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.Education/Experience: Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred. 2+ years of clinical nursing experience. Acute care experience preferred Knowledge of healthcare and managed care preferred.Licenses/Certifications: Current states LPN/LVN or RN license.For North Carolina only: In addition, these individuals will conduct utilization management activities, including but not limited to prior authorization, concurrent review and retrospective review. Must reside in North Carolina, and be NC licensed nurse and/or licensed behavioral health professional in good standing.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.by Jobble

Keywords: Carolina Complete Health, Cary , Concurrent Review Nurse I (Durham County), Healthcare , Morrisville, North Carolina

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Internal Medicine position in VA (Physician #)
Description: Internal Medicine opening in Virginia - Located in Danville, VA - Greensboro, NC 47m, Raleigh 75m - Full-time, permanent position - Hospital is licensed for 250 beds with 150 primary care and specialty (more...)
Company: Archway Physician Recruitment
Location: Danville
Posted on: 04/12/2021

Travel Cytotechnologists
Description: Travel Cytotechnologist Numerous Nationwide Travel Assignments / Jobs br br Tired of completing an application just to get informationClick the View or Apply button for HCEN's Free, Quick Short (more...)
Company: HealthCare Traveler (Allied Health)
Location: Wilson
Posted on: 04/12/2021

Intensive Care Burn Unit RN - Travel Assignments
Description: Intensive Care Burn Unit RN - Nationwide Travel Nurse AssignmentsAre you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking (more...)
Company: HealthCare Traveler Jobs
Location: Wilson
Posted on: 04/12/2021


Experienced Travel RNs - ICU, CVICU, SICU, MICU, NICU, PICU
Description: Travel Nurses Needed - All RN Specialties br Registered Nurses: Critical Care ICU, CVICU, SICU, MICU br Hospitals are posting their seasonal staffing needs br Would you like to spend the fall / (more...)
Company: RN Travel HealthCare Jobs
Location: Danville
Posted on: 04/12/2021

Travel Nurse Coronary Care Unit RN-CCU
Description: Travel Nurse Coronary Care Unit RN Registered Nurse br CCU Travel Nurse Jobs Assignments br Looking for a CCU travel assignment You are in the right place, the HCEN Network of staffing agencies (more...)
Company: RN Travel HealthCare Jobs
Location: Wilson
Posted on: 04/12/2021

RRT - Respiratory
Description: Fortus Healthcare Resources is seeking a Travel Respiratory RRT for an immediate opening in Danville, VA .When you join the Fortus team, you become part of our family,
Company: Fortus Healthcare Resources
Location: Danville
Posted on: 04/12/2021

Dentist - DDS / DMD
Description: Dentist - DDS / DMDApply Now OverviewWhen you say Yes to Aspen Dental, you get a great career and so much more. From mentors invested in your success, to a support network that has your back, joining (more...)
Company: Aspen Dental
Location: Wilson
Posted on: 04/12/2021

Nursing
Description: Source Medical Staffing believes that making a difference matters. We come to work every day to make a difference,
Company: Source Medical Staffing, LLC
Location: Wilson
Posted on: 04/12/2021

Wound Care Physician Job in Danville, VA
Description: Wound, Burn and Ostomy opening in Danville, Virginia. This and other physician jobs brought to you by DocCafe.com DirectShifts is seeking a Wound Care Physician to work in Danville, VA. This is a Full (more...)
Company: DirectShifts
Location: Danville
Posted on: 04/12/2021

RRT
Description: Our Story: Fusion isn't just a job it's a lifestyle. Our actions are rooted in ensuring everyone we touch has a better life. Here, we don't just work hard and play hard every day we do it with a purpose. (more...)
Company: Fusion Medical Staffing
Location: Danville
Posted on: 04/12/2021

Log In or Create An Account

Get the latest North Carolina jobs by following @recnetNC on Twitter!

Cary RSS job feeds