✨ About The Role
- The role involves performing initial and concurrent reviews of inpatient cases using evidence-based criteria.
- Collaboration with facility healthcare professionals to obtain plans-of-care is a key responsibility.
- The position requires participation in discussions with the Clinical Services team to improve care progression.
- Candidates will consult with Medical Directors for complex cases and manage care delays effectively.
- Maintaining compliance with Federal, State, and accreditation organizations is crucial in this role.
⚡ Requirements
- A current and unrestricted Compact RN license is essential for this role.
- Candidates should have at least 3 years of clinical nursing experience in settings such as Acute Inpatient, SNF/AIR/LTAC, or Emergency Department.
- Experience with utilization review and evidence-based guidelines, specifically MCG and InterQual Guidelines, is required.
- Proficiency in computer skills, including Microsoft Suite and clinical platforms, is necessary for effective case management.
- A Bachelor’s degree and certification in Case Management (CCM) are preferred qualifications that can enhance a candidate's profile.