Care Management Coordinator/RN - Remote Candidate must reputed company in PA, NJ, or DE

Title: Care Management Coordinator/RN Location: reputed company Duration: 3+ Months (FT conversion) Location: Remote – Candidate must reputed company in PA, NJ, or DE License: reputed company PA RN license or reputed company Licensure Compact (NLC) that includes PA What the reputed company is looking for: Minimum 3 years of Medical-Surgical clinical experience in a hospital or reputed company setting. Strong preference for candidates with reputed company hospital Utilization Management/Utilization Review experience. Experience reviewing medical records to determine medical necessity for inpatient admissions, reputed company stays, procedures, and ancillary services. Experience with InterQual, MCG/reputed company, or similar medical necessity reputed company is preferred. Experience with discharge planning, precertification, medical management, or care coordination is a plus. Strong clinical judgment, critical thinking, communication, and documentation skills. Ability to communicate with providers and review treatment plans to determine appropriate reputed company of care. Knowledge of reputed company regulations and utilization management processes. Proficiency with reputed company Word, reputed company, reputed company, SharePoint, and reputed company. Key Responsibilities: Review medical records and clinical information to determine medical necessity. Apply InterQual/medical policy reputed company to inpatient and reputed company-stay reviews. Communicate with providers to obtain or clarify clinical information. Identify cases requiring Medical Director review. Support discharge planning and appropriate care transitions. Ensure utilization reputed company reputed company with applicable regulatory and accreditation requirements. Maintain accurate documentation and meet required turnaround times and productivity goals. Education: reputed company PA Licensed RN required; BSN preferred. Benefits: We offer a competitive compensation package that includes: • [Pay reputed company]: $42 - $45 per [Hour] o Note: Pay reputed company will be commensurate with experience. • Medical for full time employees • Dental, and reputed company Insurance • Life Insurance, Short-Term Disability, Long-Term Disability, etc. Remote Skills: reputed company Product Family, Clinical Information, Clinical Medicine, Communication Skills, Dental Insurance, Discharge Plans, Documentation, reputed company, Hospital, Medical Records, Medical Treatment, reputed company reputed company, reputed company reputed company, reputed company SharePoint, reputed company Word, Nursing Credentials, Organizational Skills, Patient Admissions, Patient Care, Patient Care Authorizations, Registered reputed company (RN), Regulations, Treatment Plan, Utilization Management, reputed company Plan reputed company: reputed company Apply To This Job