A company is looking for a Care Coordinator - Retrospective RN.
Key Responsibilities
Perform medical necessity reviews for inpatient, outpatient, and retrospective services
Consult with Medical Directors regarding care that does not meet established criteria
Document clinical information accurately and maintain compliance with regulatory requirements
Required Qualifications
Bachelor's degree or four years of relevant work experience (REQUIRED)
Current State Licensure as a registered nurse (REQUIRED)
Three years of clinical experience (REQUIRED)
Experience in Utilization Management
Experience in the health plan industry
Care Coordinator • Lakeland, Florida, United States