Care Review Clinician

healthcaresupportstaffing1
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📍 MI📍 Troy📍 Troy, MI, United States📍 usFull time

About this role

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

  • Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time.  
  • Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review.
  • Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

Qualifications

  • Must be an RN
  • Inpatient HOSPITAL UR: Prior Auth, Concurrent Rev.  (6 months)- Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures
  • NCQA experience ( at least one recent year)
  • Interqual or Milliman (MCG) experience 
  • Other basic computer skills necessary: Microsoft Office, Data Entry, etc. 
  • Minimum 2-4 years of clinical practice.                    

Additional Information

Hours:

 Mon-Fri 8:30am-5pm

Advantages:

Competitive Pay ($33/hr. to $37/hr)

Benefits offered!

Great work environment!

Want to hear more information? 

Reach out to Jeff St Louis for immediate consideration by calling 407-478-0332 ext. 223!


Frequently Asked Questions

Is the salary disclosed for the Care Review Clinician position at healthcaresupportstaffing1?
The salary for this Care Review Clinician role at healthcaresupportstaffing1 is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Care Review Clinician position at healthcaresupportstaffing1 located?
This Care Review Clinician role at healthcaresupportstaffing1 is based in MI, Troy, Troy, MI, United States, us. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Care Review Clinician role at healthcaresupportstaffing1 full-time or part-time?
This is listed as a Full time position. It is posted as a Care Review Clinician role at healthcaresupportstaffing1.
How do I apply for the Care Review Clinician position at healthcaresupportstaffing1?
Click the "Apply Now" button on this page. You will be redirected to healthcaresupportstaffing1's official application portal hosted on smartrecruiters where you can submit your application directly.
When was the Care Review Clinician job at healthcaresupportstaffing1 posted?
This Care Review Clinician position at healthcaresupportstaffing1 was posted on Mar 22, 2017. Apply as soon as possible — early applications are often reviewed first.
Care Review Clinician
healthcaresupportstaffing1
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