Care Review Clinician III - CCS Experience

Location: Long Beach
Posted on: October 29, 2024

Job Description:

Prominent managed care organization is seeking a Care Review Clinician III to work in Long Beach, CA.

This is a three (3) to six (6) month contract position with the possibility of extension/temp-to-hire.

Maximum pay is $48.00/hour.

Summary:

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing plan members with the right care at the right place at the right time. Specifically, this role will be responsible for determining if a patient has a California Childrens' Services eligible condition, and creating application if eligible.

Requirements:

Minimum 5-7 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.

Valid, unrestricted CA RN or LVN license in good standing

California Children Services- experience preferred

UM experience- at least 2 years

Prior Auth experience

Concurrent Review experience We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.

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