Clinical - Clinical Review Nurse - Concurrent Review
Clinical - Clinical Review Nurse - Concurrent Review
Posted on :
27-10-2024
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Job Description
Job Description:
Job Title: Clinical Review Nurse Concurrent Review
Location: Remote
Duration: 6 months (Possible Extension)
Shift Timing: Monday through Friday 8am to 5pm
Job Summary:
Walk me through the daytoday responsibilities of this role and a description of the project (Outside of Workday JD):
- Responsible for managing facilities for acute care in patient stays.
- Initial reviews concurrent stay review & discharges (beginning middle & end)
- Being a team player lots of collaboration
- Role is independent but the team works together on many items.
- Being able to prioritize tasks.
Describe the performance expectations/metrics for this individual and their team:
- Productivity metrics how many authorizations they complete per day.
- Weighted productivity credit is given for certain tasks (sending out a denial letter building an authorization gathering additional details & information)
- Team does complete audits may be more relevant when they are converted (meeting criteria completing authorizations appropriately)
- High pressure turnaround times (sometimes they must be able to complete an authorization within 24 hours)
Tell me about what their first day looks like:
- 4week training with learning and development once completed they will be working with the preceptor (no exact timeline based on individual performance & understanding)
- Will be working within TruCare Interqual (will be trained on systems)
- IT training
- Compliance training
- Will be assigned a preceptor that will be there to support them through training and ensuring they are on the right path
What previous job titles or background work will be in this role
- UM experience prior authorization.
- What makes your team/department/culture special that you would like candidates to know
- Not having acute care experience Team will hire LPN but generally they do not have the experience the team needs (physician office nursing home)
Employment Type
Full Time
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