Immediate need for a talented Concurrent Review RN. This is a 06+ Months Contract opportunity with long-term potential and is located in USA (Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID:26-33569
Pay Range: $38 - $40.50/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:
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.
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Job ID:26-33569
Pay Range: $38 - $40.50/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:
- Perform concurrent reviews to assess member health and appropriateness of care settings.
- Evaluate quality and continuity of care by analyzing acuity levels, resource consumption, and discharge planning.
- Collaborate with Medical Affairs and Medical Directors to discuss member care.
- Document concurrent review findings and maintain accurate medical records in health management systems.
- Work with healthcare providers to approve medical determinations based on concurrent review findings.
- Educate providers on utilization processes to ensure high-quality care.
- Provide feedback to leadership on opportunities to improve care levels and medical necessity.
- Review member transfer or discharge plans for timely transitions between care levels.
- Collaborate with care management on member referrals.
- Conduct clinical medical necessity reviews, maintaining an expectation of 14 reviews per day.
- 2+ years of acute care experience required.
- Graduate from an Accredited School of Nursing.
- Licensed nurse in the state of Oklahoma.
- Ability to work autonomously and efficiently.
- Fast learner with the capability to research for knowledge.
- Task-oriented with strong organizational skills.
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