Fully Remote Clinical Review Nurse

Remote Full-time
Job Description

Job Description...

A-Line is now hiring a Fully Remote Clinical Review Nurse in California (Must reside in state). This would be full time / 40+ hours per week.

If you are interested in this Fully Remote Clinical Review Nurse position, please email Heather Foret [email protected], call Heather at 847-798-6487, or apply to this posting!

Clinical Review Nurse Compensation
Ā• The pay for this position is $40.00 per hour
Ā• Benefits are available to full-time employees after 90 days of employment
Ā• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Clinical Review Nurse Highlights
Ā• Hours are Monday through Friday 8am Ā– 5pm PST

Clinical Review Nurse Responsibilities
Ā• Review concurrent and continued stay requests to ensure appropriate care and setting, following established guidelines and policies.
Ā• Approve services or escalate requests to the Physician or Medical Director for secondary review.
Ā• Complete medical necessity and level of care assessments for requested services using InterQual guidelines, referring to Medical Directors based on case findings.
Ā• Collaborate with staff within provider networks and the discharge planning team, both electronically and telephonically, to coordinate member care.
Ā• Conduct discharge planning activities to facilitate effective transitions of care.
Ā• Educate providers on utilization and medical management processes.
Ā• Provide clinical knowledge and serve as a resource to non-clinical team members.
Ā• Enter and maintain relevant clinical information in various medical management systems.

Clinical Review Nurse Requirements
Ā• High School Diploma or GED
Ā• 2-4 years of hospital, Managed care, or UM experience
Ā• Graduate from an accredited School of Nursing Ā– California RN
Ā• Microsoft experience and EMR experience

If you think this Fully Remote Clinical Review Nurse is a good fit for you, please reach out to me by e-mail, or apply to this posting!

Heather Foret Ā– Recruiting Assistant

[email protected]

Apply Now

Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Senior Product Manager Salesforce CRM & Analytics (Healthcare Payer)

Remote Full-time

Teacher, Special Education – Autism Spectrum Disorders (ASD) 2023 in Spring Hill, FL in Pasco County Schools (job Id: 1691387439)

Remote Full-time

**Experienced Full Stack Software Engineer – Web & Cloud Application Development**

Remote Full-time

**Experienced and Entry-Level Customer Support Representatives Wanted at blithequark – Remote Opportunities**

Remote Full-time

Fractional CMO Needed to Drive Lead Gen for $1.5M Mastermind (Direct Response + Facebook Ads)

Remote Full-time

Senior Software Engineer

Remote Full-time

Corporate Learning and Development Specialist

Remote Full-time

Apply Now: Content Editor – North America

Remote Full-time

Join Today: Part-Time American Express Data Entry Remote Jobs

Remote Full-time

**Job Title:** Experienced Global Customer Solutions Specialist - Remote Opportunity at blithequark

Remote Full-time
← Back to Home