FresnoRecruiter Since 2001
the smart solution for Fresno jobs

Concurrent Review Nurse II

Company: Centene Coproration
Location: Fresno
Posted on: December 5, 2019

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 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 Direct care to participating network providers Participate in utilization management committees and work on special projects related to utilization management as needed For New Hampshire and Massachusetts - home visits required

Keywords: Centene Coproration, Fresno , Concurrent Review Nurse II, Healthcare , Fresno, 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


Pharmacy Technician II
Description: Description: Position Purpose: Track and triage all coverage determination requests for prior authorizations and Medicare
Company: Centene Coproration
Location: Fresno
Posted on: 12/13/2019

Psychiatrist
Description: Position Summary br br Life in the Air Force can add unique pressures in addition to the normal stresses of daily life. Specializing in the diagnosis, treatment and prevention of mental health and (more...)
Company: U.S. Air Force
Location: Fresno
Posted on: 12/13/2019

General Surgery
Description: Position Summary br br Sometimes the only way to diagnose, repair or treat medical problems is through surgery. Specializing in operating room procedures, Surgeons provide critically intricate care (more...)
Company: U.S. Air Force
Location: Fresno
Posted on: 12/13/2019


Registered Nurse - ICU - 13 Week Contract
Description: We're hiring a highly skilled Registered Nurse experienced in responding to life-saving situations of seriously ill patients that require immediate and continuous attention for a 13 week contract assignment (more...)
Company: Jackson Nurse Professionals
Location: Fresno
Posted on: 12/13/2019

Newborn Nursery - RN - Travel (Fresno,CA)
Description: Registered Nurse.
Company: HealthCare Traveler Jobs
Location: Fresno
Posted on: 12/13/2019

Seeking OBGYN Provider in Fresno, CA (Physician #)
Description: li Seeking OBGYN Provider br Locum coverage for inpatient/outpatient br Fresno, CA br Start ASAP- Dec 2019 br Credentialing can take 120 days
Company: Provider Healthcare
Location: Fresno
Posted on: 12/13/2019

Emergency Services Physician
Description: Position Summary br br When Airmen or their families have a medical emergency, time can be of the essence. Focused on immediate decision-making and treatment, Emergency Services Physicians take the (more...)
Company: U.S. Air Force
Location: Fresno
Posted on: 12/13/2019

OR Pediatric Surgery Travel Nurse RN
Description: Nationwide Travel Nurse Jobs - Pediatric Surgery RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...)
Company: HealthCare Employment Network
Location: Fresno
Posted on: 12/13/2019

Neuro ICU - Critical Care Unit RN - Travel (Fresno,CA)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Fresno
Posted on: 12/13/2019

Pharmacy Technician II (CPHT Required)
Description: Pharmacy Technician II CPHT Required Position Purpose: Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients - Track and triage coverage determination (more...)
Company: Centene
Location: Fresno
Posted on: 12/13/2019

Log In or Create An Account

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

Fresno RSS job feeds