Case Manager - RN
Prince George's County , MD | Healthcare
We are searching for Full-Time, contract Registered Nurses to perform Case Management in a hospital setting. The RNs will be doing the following:
- Assesses the medical necessity and quality of inpatient admissions, outpatient services, surgical and diagnostic procedures, and other covered services by conducting pre-certification, concurrent, and retrospective reviews
- Applies clinical review criteria, guidelines, and screens in determining the medical necessity of health care services
- Consults with physician/practitioner consultants when reviews fail clinical review criteria, guidelines, and screens
- Refers cases to other professionals internally, as well as to customers and other appropriate external sources when indicated
- Meets performance expectations on quality metrics
- Meets performance expectations on quantity metrics
Dependable transportation is required. RNs MUST have a current MD License. We are hiring immediately, please submit your resume to email@example.com for immediate and confidential review.
1. MINIMUM of 3 years of Case Management/ Chart Review experience, preferably in an Acute Care Hospital.
2. Valid (or renewable) MD License
3. Strong Microsoft Word, Excel and typing skills
NRI is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability.