Review inpatient admissions to assure appropriate level of care and medical necessity.
At least two years clinical nursing experience.
- Review admissions through on-site and telephonic review to ensure medical necessity and appropriate level of care.
- Review and audit patient charts through on-site hospital visits.
- Act as clinical resources to referral staff and make appropriate referrals.
- Provide patient and provider education.
- Data enters assessments, authorizations and reviews into the system.
RN required. Current state nursing license. UM certificationpreferred.
Centene is sensitive to the needs of individuals and families enrolled in government-assisted health programs. The company provides managed...