Pyramid Consulting, Inc
Registered Nurse – RN Utilization Review / Discharge Planning.
Pyramid Consulting, Inc, California, Missouri, United States, 65018
Registered Nurse – RN Utilization Review / Discharge Planning.
Immediate need for a talented
Registered Nurse – RN Utilization Review / Discharge Planning . This is a
06+months contract
opportunity with long-term potential and is located in
Santa Jose, California (Onsite) . Please review the job description below and contact me ASAP if you are interested.
Job ID: 24-22303
Pay Range: $60- $65/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities
Perform daily pre-admission, admission, and concurrent utilization reviews
Apply InterQual® and/or MCG® criteria to determine medical necessity and level of care
Assess readiness for discharge and continued status
Educate care teams on utilization and care coordination processes
Coordinate inpatient discharge planning and transitions of care
Participate in multidisciplinary rounds and care planning discussions
Arrange authorizations, transfers, and post-acute services
Ensure continuity of care through clear documentation
Regulatory & Compliance
Ensure compliance with CMS, DMHC, NCQA, TJC, HIPAA, ERISA, EMTAL
Accurately interpret and apply member healthcare benefits
Key Requirements and Technology Experience
Minimum 2 years of inpatient utilization management, case management, or discharge planning experience
Acute inpatient hospital experience required
Licensure & Certifications: BLS Certification (Required)
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Our client is a leading Healthcare organization and we are currently interviewing to fill this and similar contract positions. If you are interested in this position, please apply online for immediate consideration.
#J-18808-Ljbffr
Registered Nurse – RN Utilization Review / Discharge Planning . This is a
06+months contract
opportunity with long-term potential and is located in
Santa Jose, California (Onsite) . Please review the job description below and contact me ASAP if you are interested.
Job ID: 24-22303
Pay Range: $60- $65/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities
Perform daily pre-admission, admission, and concurrent utilization reviews
Apply InterQual® and/or MCG® criteria to determine medical necessity and level of care
Assess readiness for discharge and continued status
Educate care teams on utilization and care coordination processes
Coordinate inpatient discharge planning and transitions of care
Participate in multidisciplinary rounds and care planning discussions
Arrange authorizations, transfers, and post-acute services
Ensure continuity of care through clear documentation
Regulatory & Compliance
Ensure compliance with CMS, DMHC, NCQA, TJC, HIPAA, ERISA, EMTAL
Accurately interpret and apply member healthcare benefits
Key Requirements and Technology Experience
Minimum 2 years of inpatient utilization management, case management, or discharge planning experience
Acute inpatient hospital experience required
Licensure & Certifications: BLS Certification (Required)
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Our client is a leading Healthcare organization and we are currently interviewing to fill this and similar contract positions. If you are interested in this position, please apply online for immediate consideration.
#J-18808-Ljbffr