Registered Nurse (RN) 38187 – V-Tech Solution – Phoenix, AZ

Job title: Registered Nurse (RN) (38187)

Location: Phoenix, AZ 85012

Duration: 8+ Months
Description
Security Comments

· Please submit resume along with proof of RN License.

· Active AZ RN License.

· Level 1 Fingerprint Clearance Card required.

· 7Year BG check will need to be completed upon offer.

· Drug Screen via HireRight will need to be completed upon offer.

Position Description

Description of duties

· Participate in educational 1:1 training/orientation on CMDP concurrent review, care coordination for children in out of home care and CMDP’s web based data management system.

· Performs concurrent hospital review.

· Reviews clinical records for assessment of the initial hospital admission days.

· Enters the member specific information noted into inpatient surgical care guidelines (MCG) to determine if the hospitalization meets criteria for approval and to document the proactive discharge plan.

· Participates in utilization and review process (UPR) with designated Medical Director.

· Documents authorization decisions including determination decision with rationale, and conduct required follow-up with requesting facility.

· Staff all readmissions within 30 days with Medical Director in UPR.

Skills/Requirements

· Required past experience/expertise with conducting concurrent reviews for members during inpatient hospitalizations. (please note this experience on resume)

· Triage experience preferred

· Considerable skill in oral and written communication

· Considerable skill in clinical problem solving

· Bilingual (Spanish) a plus but not required

Knowledge

· Administration of health care and clinical standards for children with chronic health/medical conditions.

· Microsoft applications.

· MCG Care Guidelines.

Ability

· Clearly identify problem, analyze situation, and rectify quality of care concerns.

· Work under pressure in a high pace environment.

Work Hours:

· M-F, 8 AM – 5 PM

Contract length: 8 months

Job Types: Full-time, Contract

Pay: $34.00 per hour

Experience:

• Administration of health care and clinical standards : 2 years (Preferred)
• Conducting reviews for members during hospitalizations: 1 year (Required)
• Triage experience: 1 year (Preferred)
• MCG Care Guidelines: 2 years (Preferred)

License:

• Level 1 Fingerprint Clearance Card (Required)
• AZ Registered Nurse (RN) (Required)

Language:

• Spanish (Preferred)

Work Remotely: