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
• The pay for this position is $40.00 per hour
• Benefits are available to full-time employees after 90 days of employment
• 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
• Hours are Monday through Friday 8am – 5pm PST
Clinical Review Nurse Responsibilities
• Review concurrent and continued stay requests to ensure appropriate care and setting, following established guidelines and policies.
• Approve services or escalate requests to the Physician or Medical Director for secondary review.
• Complete medical necessity and level of care assessments for requested services using InterQual guidelines, referring to Medical Directors based on case findings.
• Collaborate with staff within provider networks and the discharge planning team, both electronically and telephonically, to coordinate member care.
• Conduct discharge planning activities to facilitate effective transitions of care.
• Educate providers on utilization and medical management processes.
• Provide clinical knowledge and serve as a resource to non-clinical team members.
• Enter and maintain relevant clinical information in various medical management systems.
Clinical Review Nurse Requirements
• High School Diploma or GED
• 2-4 years of hospital, Managed care, or UM experience
• Graduate from an accredited School of Nursing – California RN
• 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 – Recruiting Assistant
