Job Description

Job Description:

Job Title: Clinical Review Nurse - Concurrent Review

Location: Remote

Duration: 3 months (Possible Extension)

Shift Timing: Monday through Friday 8am to 5pm (Any Time Zone)

Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):

• Responsible for managing facilities for acute care in patient stays.
• Initial reviews, concurrent stay review & discharges (beginning, middle & end)
• Being a team player lots of collaboration
• Role is independent but the team works together on many items.
• Being able to prioritize tasks.

Describe the performance expectations/metrics for this individual and their team:

• Productivity metrics how many authorizations they complete per day.
• Weighted productivity credit is given for certain tasks (sending out a denial letter, building an authorization, gathering additional details & information)
• Team does complete audits may be more relevant when they are converted (meeting criteria, completing authorizations appropriately)
• High pressure turn around times (sometimes they must be able to complete an authorization within 24 hours)

Tell me about what their first day looks like:

• 4 week training with learning and development once completed they will be working with the preceptor (no exact timeline, based on individual performance & understanding)
• Will be working within TruCare, Interqual (will be trained on systems)
• IT training
• Compliance training
• Will be assigned a preceptor that will be there to support them through training and ensuring they are on the right path

What previous job titles or background work will be in this role?

• UM experience, prior authorization.

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