What are the responsibilities and job description for the Care Review Clinician I position at AltaStaff, LLC?
Job Description
Job Description
AltaStaff is a staffing agency currently looking for a Care Review Clinician I to work with our Managed Care Client!
Pay Rate : $38 - 40 hourly
Schedule : Monday -Friday 8am-5pm or 9am-6pm MST
- This is a fully remote role but candidates must have RN or LPN / LVN license in New Mexico
Position Purpose : Care Review Clinician works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. Assesses members for care needs, and develops treatment plans with practitioners, providers, members and support system.
Assesses and responds to patient / family needs by coordinating efforts of other team members and identifies and resolves barriers that hinder effective patient care.
May coordinate for medical service / appointments once discharge is complete and make the necessary community resource referrals.
Identifies appropriate benefits, eligibility, and expected length of stay for requested treatments and / or procedures.
Analyze clinical service requests from members or providers against evidence based clinical guidelines
Process requests within required timelines
Refer appropriate cases to Medical Directors and presents cases in a consistent and efficient manner
Request additional information from members or providers in consistent and efficient manner and appropriate referrals to other clinical programs
Additional duties assigned
Education / Experience :
RN or LPN / LVN license in NM required
Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse program
Must have 1-3 year experience working in home health OR 1-3 yrs Utilization Management experience; MCG experience preferred
Experience working in acute care / medical surgical
Area of expertise should be specific to inpatient reviews
Must have solid experience within a clinical setting as they must be able to use their knowledge to extrapolate key information during the authorization process
AltaStaff is an Equal Employment Opportunity Employer. We provide equal employment opportunities to all qualified applicants for employment without regard to age, race, color, creed, religion, sex, marital status, national origin, ancestry, citizenship, disability, veteran status, sexual orientation, or any other protected status, in accordance with applicable federal, state, and local laws.
Salary : $38 - $40
