Title: Clinical Review Nurse - Concurrent Review
Duration: 06 Months with potential to extend
Location: TX Remote
10am-7pm CST, Schedule can be Sun-Thurs or Tues-Sat

Position Summary: The nurse will be reviewing about 20 cases a day to review for medical necessity on a member that admits to the hospital. Job is to advocate and protect the member from unnecessary admissions to the hospitals.

Key Responsibilities:

• Nurse has to follow many changes and processes to complete the authorizations.
• Will be working with a group of nurses to assist each other and collaborate on getting the cases done.
• The nurse will be in contact with doctors and case managers to achieve decisions and/or receive more information about the member’s condition/status.
• Nurse will be using multiple resources we have to achieve successful completion of the cases.
  
  Qualification & Experience:

Candidate Requirements
Education/Certification	Required: RN			Preferred:
Licensure	Required: RN,			Preferred:
Years of experience required Disqualifiers Best vs. average Performance indicators		Must haves: 2-4 years of hospital experience, multi tasking, time management, quick learner, go with the flow attitude, computer savvy   Nice to haves: UM, Clinical/managed care experience   Disqualifiers: unable to multi task, disorganized, not willing to make calls, not computer savvy   Performance indicators: Will be monitoring productivity daily
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection		1	TX RN license or compact state license
		2	Communication skills
		3	Documentation/Computer skills

 

 


At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $39.44/hr.