TRA Utilization Review - California RN License
This position is approximately 20 hours a week* $74 an hour This RN Utilization Review contract position requires 2 years Acute Care Utilization Review experience; not from an insurer's perspective but your employer MUST have been an Acute Care facility when you practiced and provided UR services. You must bring two years of providing Utilization Review services for an Acute Care Hospital employer to be considered. (Job Titles or primary experience as a Case Manager or Social Worker will not be considered.) This is a contract position and; therefore, requires you 'hit the ground' running and no job training is provided. You will be oriented to our systems only. 1 - You will bring your knowledge of Acute Care UR, from working for an Acute Care employer, to make a positive impact with us from Day 1. You MUST also have a California RN license. 2 - You must have used AllScripts, Cerner AND Interqual while working in a Utilization Review role for a hospital employer. 3 - If you resume does not show the job title 'Utilization Review' attached to a hospital employer and Allscripts, Cerner and Interqual, then, update your resume and add this to your resume before you submit it for this role. If your resume does not specifically show these items, your resume will not be considered. The RN Utilization Review is responsible to facilitate care along a continuum through effective resource coordination · Utilization Management supporting medical necessity and denial prevention · Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction · Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care · Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy · Education provided to physicians, patients, families and caregivers REQUIREMENTS Must have BLS Must have Titer and immunization record up to date even though this is a remote position We are a nationwide hospital system and require for all remote employees that all health records are up-to-date in the possibility that any remote employee walks on-site to one of our hospital facilities. Apply Job!