REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. JOB RESPONSIBILITIES This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance to contract guidelines. Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities. JOB QUALIFICATIONS (Required) Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations. 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company. Knowledge of medical terminology and procedures. Verbal and written communication skills. JOB QUALIFICATIONS (Preferred) MCG or InterQual experience Utilization management experience LOCATION REMOTE in Texas (Austin area – Travis/Williamson Counties or Richardson area – Dallas/Collin Counties). POSITION 6-month assignment SALARY $38 - $40 hourly HOURS PER WEEK 40 HOURS PER DAY 8 #J-18808-Ljbffr
...Healthcare consultant ~ Charter member of NALTO " Since 1995, Weatherby Healthcare has established itself as an expert in locum tenens staffing for physicians, physician assistants, and nurse practitioners. The company employs nearly 600 employees committed to...
**Description** **Location:** St. Louis, MO (Onsite) **Reports To:** Vice President, Global Supply Chain & ESG **Scope:** Global - United States, China, Singapore **Travel Requirement:** Some international travel, including travel to China **Number of Direct Reports...
...Lifting up to 75 lbs. unassisted is required, though infrequent (less than half shift).Assistance for Individuals with Disabilities Wayfair is fully committed to providing equal opportunities for all individuals, including individuals with disabilities. As part of this...
...Job Type Temporary Description Saint Andrew's Episcopal School is looking for coaches for multiple sports throughout the school year from August through May. Coaches should have experience in the sport at the youth level, high school, college level...
...Looking for something different than the typical part-time job? Were hiring Event Hosts (GameCoaches) in Jacksonville to run video game parties and group events. This is an active, social job where youre leading the experience not just watching it happen. What...