ChicoRecruiter
the smart solution for Chico jobs

Concurrent Review Nurse II

Company: Centene Corporation
Location: Chico
Posted on: October 30, 2018

Job Description:

HourlyPosition 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 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 programs Licenses/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._ **TITLE:** Concurrent Review Nurse II **LOCATION:** Chico, California **REQNUMBER:** 1097744 **COMPANY:** Clinical & Nursing **POSITION TYPE:** Hourly

Keywords: Centene Corporation, Chico , Concurrent Review Nurse II, Healthcare , Chico, 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


L&D Travel RN Needed in Sacramento, CA
Description: Job Summary:The Staff Nurse SN II is a professional caregiver who assumes responsibility and accountability for a group of patients for a designated time frame. The SN II provides care to patients via (more...)
Company: Travel Nurses, Inc.
Location: Sacramento
Posted on: 11/17/2018

Addiction Medicine Physician-Any Specialty- Weekends- Flexible Hours!
Description: US-CA-Sacramento br Category MD / DO br br br Overview br br Dr. Cruiter has been retained by a prominent 48 bed Detox/Recovery
Company: Hiring Companies
Location: Sacramento
Posted on: 11/17/2018

Registered Nurse (RN) - 3 EAST
Description: br ALL Units Admitting Telemetry --Patients br br Dysrhythmia recognition course or demonstrated competency and br ACLS required. br br Critical Care Units br br Dysrhythmia recognition (more...)
Company: Rideout Health
Location: Marysville
Posted on: 11/17/2018


RN-Med Surg/Telemetry (7:00 AM-7:00 PM)
Description: Call today to speak
Company: Convergence Medical Staffing
Location: Sacramento
Posted on: 11/17/2018

ICU/CCU RN
Description: trustaff is currently seeking an experienced ICU/CCU Registered Nurse for a 13-week travel contract. The Intensive Care Unit ICU RN provides care for patients with life-threatening medical conditions. (more...)
Company: trustaff
Location: Fairfield
Posted on: 11/17/2018

Travel Cath Lab RN, 8H Days 7:00 AM - 3:00 PM
Description: Travel Cath Lab RN Carmichael, CA br Location: nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbspCarmichael, CA br Start Date: nbsp nbsp nbsp nbsp nbsp nbsp nbsp11/14/2018 br Shift Details: nbsp nbsp (more...)
Company: Triage Staffing
Location: Carmichael
Posted on: 11/17/2018

Carmichael, California - Telemetry(142305)
Description: Registered Nurse, Telemetry br br Position open--Carmichael, California br br ShiftType 7A-7P br br
Company: Atlas MedStaff
Location: Carmichael
Posted on: 11/17/2018

Case Manager RN - Travel
Description: GetMed Staffing is seeking a qualified traveler
Company: GetMed Staffing
Location: Sacramento
Posted on: 11/17/2018

Emergency RN
Description: trustaff is currently seeking an experienced Emergency Registered Nurse for a 13-week travel contract. The Emergency Room RN provides care for patients with a variety of illnesses or trauma requiring (more...)
Company: trustaff
Location: Roseville
Posted on: 11/17/2018

Labor and Delivery RN - Travel
Description: GetMed Staffing is seeking a qualified traveler
Company: GetMed Staffing
Location: Lodi
Posted on: 11/17/2018

Log In or Create An Account

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

Chico RSS job feeds