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Case Manager I

Centene Corporation Type Full time Posted 6/27/2014
Salary - n/a - Starts - n/a -
MA - Massachusetts (All) - Waltham Referral - n/a -    

Case Manager I (Concurrent Review) - 004N7

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.
  • Provide patient and provider education.
  • Data enters assessments, authorizations and reviews into the system.


 

Qualifications

Knowledge/Experience: At least two years clinical nursing experience.

Licenses/Certifications: RN required. Current state nursing license. UM certification preferred. For Washington only – current state’s driver license.

Job: Clinical & Nursing

Primary Location: USA-Massachusetts-Waltham

Organization: CeltiCare

Schedule: Full-time