Telephonic Concurrent Review Nurse Job Description:
Universal Health Care Group, a privately held managed care company, is in immediate need of a full-time Telephonic Concurrent Review Nurse to contact facility case managers, discharge planners, and physicians to ensure members are receiving medical services in the appropriate setting at the appropriate level without compromising the quality of care received. The Telephonic Concurrent Review Nurse will be responsible for ensuring cost effective and quality patient care by appropriate utilization of resources; overseeing concurrent review for members admitted to acute and skilled nursing facilities both In-network and out-of-network and out of the service area, and managing appropriate discharge planning and disposition coordination for hospitalized members.
The Telephonic Concurrent Review Nurse must possess an unrestricted RN or LPN license in the State of Florida and have 1-2 years of experience in managed care. The candidate must have the ability to prioritize and follow up on assigned cases, must have the capacity to give full attention and focus on conversations details and data, and must be able to work in a team environment and maintain professional relationships. Universal Health Care Group offers a competitive salary, health, dental, and vision benefits, free gym membership, and 401k.
Qualifications: Education and Experience Requirements:
- Possession of an unrestricted RN/LPN/LVN license in the State of Florida is required.
- An equivalent combination of education and experience from which comparable knowledge and abilities can be obtained is necessary.
- One to two years of experience in managed care is required.
- Interqual experience is a plus
- Excellent phone/communication skills – able to convey key concepts clearly and succinctly.
- Active listening skills – ability to give full attention and focus on conversations details and data.
- Customer Service –strong desire to service hospitalized members, providers and vendors.
- Ability to prioritize and follow up on assigned cases.
- Teamwork – must be able to work in a team environment and maintain professional relationships.
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