PAC Nurse

Company: VirtualVocations
Location: Marietta
Posted on: September 14, 2023

Job Description:

A company is looking for a PAC Nurse.
Responsibilities:

Establish scheduled telephonic touch points with each facility point person to review each member within that facility and confirm appropriateness for continued stay
Authorize continued stay at SNF, IRF, LTACH and Home Health care (if delegated) using approved medical care guidelines and collaboration with key facility personnel within the healthcare setting
Use clinical expertise, review clinical information and clinical criteria to determine if the service/device meets medical necessity for the member

Qualifications:

Hold a current and unrestricted license as a Licensed Practical Nurse or Registered Nurse
Have Associate's Degree or Diploma in Nursing/Practical Nursing or the equivalent
Possess a minimum of 2 years clinical experience in a clinical setting
Be an expert in Utilization Management and knowledge of URAC & NCQA standards
Have a broad knowledge of health care delivery/managed care regulations and experience with evidence based care guidelines (i.e. MCG/Milliman, InterQual)

Keywords: VirtualVocations, Marietta , PAC Nurse, Healthcare , Marietta, Georgia