SacramentoRecruiter
the smart solution for Sacramento jobs

Concurrent Review Nurse II Part-Time Weekends

Company: Centene Corporation
Location: Rancho Cordova
Posted on: November 11, 2018

Job Description:

Description:Position Purpose\: 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.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 determinationsComplete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findingsCollaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member careConduct discharge planningEducate providers on utilization and medical management processesProvide clinical knowledge and act as a clinical resource to non-clinical team staffEnter and maintain pertinent clinical information in various medical management systemsDirect care to participating network providersParticipate in utilization management committees and work on special projects related to utilization management as needed--??For New Hampshire and Massachusetts - home visits requiredQualification:Education/Experience\: Graduate from an Accredited School of Nursing. Bachelor--??s degree in Nursing preferred. 2+ years of clinical nursing experience and 1+ years of utilization management experience in a managed care setting. Acute care experience preferred. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programsLicenses/Certifications\: Current state--??s LPN/LVN or RN license. For New Hampshire and Massachusetts - must obtain current state's RN license within 90 days of hire. Valid driver--??s license.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.

Keywords: Centene Corporation, Sacramento , Concurrent Review Nurse II Part-Time Weekends, Healthcare , Rancho Cordova, California

Click here to apply!

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

I'm looking for
in category
within


Other Healthcare Jobs


House Supervisor / Nurse Supervisor - Block Booking
Description: House Supervisor / Nurse Supervisor Location: Petaluma CA Shift: 8hrs/Days / 40hrs/ week Master booking 40hrs/week Start date: ASAP Pay rate: 70/hr Position Summary: Represents the facility and the (more...)
Company: Star Nursing
Location: San Rafael
Posted on: 11/16/2018

OT / Occupational Therapist
Description: OT / Occupational Therapist We are currently looking for a dynamic Occupational Therapist OT to join our team for a 13 week assignment in California. The Occupational Therapist OT will provide therapy (more...)
Company: Aureus Medical Group
Location: San Rafael
Posted on: 11/16/2018

FULL-TIME CERTIFIED NURSE ASSISTANT (CNA)
Description: FULL-TIME CERTIFIED NURSE ASSISTANT CNA Not-for-Profit, Senior Citizen Community in San Rafael is seeking a Full Time Certified Nursing Assistant to join our team. Position includes a rich employee (more...)
Company: Villa Marin Homeowners Association
Location: San Rafael
Posted on: 11/16/2018


Certified Nursing Assistant CNA
Description: ON-CALL CERTIFIED NURSE ASSISTANT CNA Not-for-Profit, Senior Citizen Community in San Rafael is seeking a Full Time Certified Nursing Assistant to join our team. Rate of Pay: To be discussed during (more...)
Company: Villa Marin
Location: San Rafael
Posted on: 11/16/2018

*Hiring CAREGIVERS, Choose Your Shifts, BENEFITS, Earn BONUSES*
Description: 92 of Honor's caregivers love their job. Why Because we treat caregivers like true professionals that's why we call them Care Pros . We pay for better performance, offer more convenient and flexible (more...)
Company: Honor Home Care
Location: Gilroy
Posted on: 11/16/2018

OT Travel Job Occupational Therapist
Description: br Jackson Therapy Partners is currently seeking a licensed Occupational Therapist for a contract position at a state-of-the-art facility where expert therapy professionals help patients with injuries, (more...)
Company: Jackson Therapy
Location: Turlock
Posted on: 11/16/2018

PACU RN Assignment: Turlock, California
Description: Travel Nurse across America is seeking a qualified Post-anesthesia
Company: Travel Nurse Across America
Location: Turlock
Posted on: 11/16/2018

Emergency Room Nurse - Emergency Nurse - Travel - (ER RN)
Description: Job Description Requirements br Emergency Room Nurse - Emergency Nurse - ER RN br StartDate: 11/27/2018Available Shifts: 12 E Pay Rate: 0.00 - 0.00 br br This unit boasts the latest in advanced (more...)
Company: Onward HealthCare
Location: Turlock
Posted on: 11/16/2018

Endoscopy Travel RN Needed in Turlock, CA
Description: Registered Nurse Endoscopy RN 13 10 Shifts Needed:
Company: Health Providers Choice
Location: Turlock
Posted on: 11/16/2018

OT - Occupational Therapist - School
Description: OCCUPATIONAL THERAPIST - OTR - SCHOOL br An Occupational Therapist is needed for a full-time 1.0 school position in San Rafael, Ca that offers a guaranteed 37.5 hours a week. This position would be (more...)
Company: Therapists Unlimited
Location: San Rafael
Posted on: 11/16/2018

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Sacramento RSS job feeds