Concurrent Review Coord Job (St. Louis, MO, US)

Coventry Health Care is a national managed health care company based in Bethesda, Maryland providing a full range of risk and fee-based managed care products and services, including HMO, PPO, POS, Medicare Advantage, Medicaid, Workers’ Compensation and Network Rental to a broad cross section of employer and government-funded groups, government agencies, and other insurance carriers and administrators. 

Coventry’s Medicaid Division is committed to guiding our members in achieving better health outcomes, to serving all of our stakeholders with the highest levels of service, and to supporting our state customers in meeting their goals. We are currently seeking an experienced Concurrent Review Coordinator to join our team.

 

The Concurrent Review Coordinator will review all inpatient admissions to assure appropriate level of care. Coordinates with physicians, staff, and facilities regarding patient care. In conjunction with and under the supervision of physicians, evaluates care plans and discharge plans, monitors all clinical activities, identifies alternative levels of care when requested care is not covered, identifies cost-effective protocols, and develops guidelines for coverage of benefits.  The successful incumbent must hold an active state RN license (preferred) or LPN license with 3+ years clinical experience and 5+ years managed care experience. A Bachelor’s degree is preferred.
Qualifications:

Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.

Job: Professionals
Primary Location: St. Louis, MO, US
Organization: 26200 - HealthCare USA - Missouri
Schedule: Full-time
Job Posting: 2012-12-17 00:00:00.0
Job ID: 1211628