Concurrent Review RN

Immediate need for a talented Concurrent Review RN. This is a 06+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested. Job ID:26-32985 Pay Range: $37 - $40.5/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities: Conduct concurrent reviews to determine the appropriateness of care and setting for members. Review quality and continuity of care by analyzing acuity levels, resource consumption, length of stay, and discharge planning. Collaborate with Medical Affairs and Medical Directors to discuss member care. Document and maintain concurrent review findings and discharge plans in health management systems. Work with healthcare providers to approve medical determinations based on concurrent review findings. Educate providers on utilization processes to promote high-quality care. Provide feedback to leadership on opportunities for improvement in care levels and medical necessity. Ensure timely discharges by reviewing transfer or discharge plans. Collaborate with care management for appropriate member referrals. Apply clinical acumen to enhance the quality and cost-effectiveness of medical care. Perform other duties as assigned. Key Requirements and Technology Experience: 2+ years of acute care experience required. Graduate from an Accredited School of Nursing. Nursing License with state of Georgia or Compact licensure. Experience in Concurrent Review Utilization Management within a Medicaid/Marketplace health plan. Proficiency with Interqual and electronic medical records. Strong computer skills (Word, Excel). Excellent written and verbal communication skills. Additional experience in healthcare and managed care. Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here. #prof