Clinical Review Nurse - Remote out of Charlotte at A-Line Staffing Solutions

A-Line Staffing is now hiring Remote Clinical Review Nurse based in Charlotte, NC. The role would be working for a major healthcare company and has career growth potential. This would be full time / 40+ hours per week.

If you are interested in this Clinical Review Nurse position, please contact Izzy P. at A-Line!

Compensation

· The pay for this position is $36-$41 per hour

· Benefits are available to full-time employees after 90 days of employment

· A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Highlights

· This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs

· The required availability for this position is 8am-5pm/9am-6p,

Responsibilities

· Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations

· Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings

· Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care

· Educate providers on utilization and medical management processes

· Provide clinical knowledge and act as a clinical resource to non-clinical team staff

· Enter and maintain pertinent clinical information in various medical management systems

Requirements

• 2+ Years clinical nursing experience
• Associates degree required
• BSN preferred
• LPN or RN certification required
• Attendance is mandatory for the first 90 days

Preferred Qualifications

· InterQual experience

· Utilization management

If you think this position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!