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JOB RESPONSIBLITIES
We have an opening for a Nursing Consultant in Topeka, KS.
REQUIRED:
• Registered Nurse (RN) or Licensed Practical Nurse (LPN) with active non-restricted license in the state of Kansas
• Minimum three years experience in an acute care setting
• Minimum one year experience in utilization management, case management, or equivalent
• Strong verbal and written communication skills
• Above average computer/technical skills
• Knowledge of medical coding including ICD-9 and CPT codes sets is desirable
• Strong clinical background
• Ability to evaluate medical records and other healthcare data
• Ability to exercise good judgement and tact in relating to contracting health care providers and Medicaid recipients
• Ability to establish and maintain effective and cooperative working relationships with HPES staff and other contacted in the course of work
• Ability to effectively prioritize multiple tasks and deadlines
JOB DUTIES:
• Timely review of prior authorization, concurrent, and retrospective review requests, both inpatient and outpatient
• Determines utilization decisions (both approval and denials) based upon nationally recognized guidelines and McKesson Interqual Criteria
• Maintains current knowledge of benefits under the Nevada Medicaid Program
• Reviews prior authorization, concurrent and retrospective review requests with the Medical Director as needed
• Maintains current and through Knowledge of McKesson Interqual Criteria
• Reviews medical records to determine appropriateness of medical services or level of care
• Performs audits of medical records as needed
• Works closely with providers to ensure coordination of care
• Assits the Health Care Manager and Department Directors in preparation for audits and other regulatory activites
CONTRACT LENGTH:
1 year with the possibility of an extension or permanent placement with client
WAGE:
$30.00/hour on a W2
LOCATION:
Topeka, KS
ADDITIONAL INFORMATION:
• Must US Citizen or green card holder
• Must be able to pass both a drug screening and criminal history check.


Location: Topeka, KS
Compensation: 30.00/hr on a W2 basis
This is a contract job.
Principals only. Recruiters, please don't contact this job poster.
Please, no phone calls about this job!
Please do not contact job poster about other services, products or commercial interests.

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Published at 01-13-2012
Viewed: 39 times