Title: Nurse RN 3
Duration: 6+ Months | Possible extension (Contract to Hire/ Temp to Perm)
Shift: 8am to 5pm or 4:30 depending on if staff member takes a hour or full hour lunch Monday - Friday.
Location: Remote CA
Day-to-day responsibilities:
Reviewing for medical Necessity all levels of care combining clinical knowledge and judgement with MCG guidelines.
Rendering decisions and or upleveling to our in-house MD for review if the nurse is unable to approve. All of this to be done within regulatory turn around times.
Our staff do not interact with members but work with the case managers and medical staff at the facilities.
Required Skills/Experience:
Strong Clinical (hands on) background
Strong Computer skills
Ability to work remote/self-directed
Education Requirement:
Current Valid Ca. RN license BSN preferred but not required
Software Skills Required:
Strong basic navigation of Microsoft EMR chart handling a plus
Disqualifiers/ Dislikes on Resumes:
Little or no hands-on clinical experience. Poor Computer Skills. Inability to follow directions or training
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