Case Manager I (Concurrent Review) - Centene (Ocala, FL)
## Description Position Purpose:
Review inpatient admissions to assure appropriate level of care and medical necessity.
Position
Responsibilities:
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.
Data enters assessments, authorizations and reviews into the system.
## Qualifications Knowledge/
Experience:
At least two years clinical nursing experience.
Licenses/Certifications:
RN, LPN or LVN required.
Current state nursing license.
UM certification preferred.
For Washington only current states driver license.
## Job Job:
Clinical Organization:
Sunshine State Health Plan Schedule:
Full-time Source:
.
Estimated Salary: $20 to $28 per hour based on qualifications.
Review inpatient admissions to assure appropriate level of care and medical necessity.
Position
Responsibilities:
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.
Data enters assessments, authorizations and reviews into the system.
## Qualifications Knowledge/
Experience:
At least two years clinical nursing experience.
Licenses/Certifications:
RN, LPN or LVN required.
Current state nursing license.
UM certification preferred.
For Washington only current states driver license.
## Job Job:
Clinical Organization:
Sunshine State Health Plan Schedule:
Full-time Source:
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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