Registered Nurse

Job description

Pediatric, geriatric, general long term care experience, previous utilization review experience . Shifts available vary between hours of 7am-7pm . "RESPONSIBILITIES: Reviews and analyzes medical necessity documentation and assessments according to established criteria and protocols. Produces decisions as required based on knowledge of Medicaid requirements and training as a Registered Nurse. Maintains appropriate documentation and support for all requests. Participates in Fair Hearings as assigned. Reviews complaints and appeals by providers; investigates and evaluates facts and advises disposition.. Manages incoming phone calls from the provider and customer communities. Cross trains to other areas and assists as required. Other duties as assigned by Manager. " Perform reviews and assessments for medical necessity. Coordinate and send to Physician for further review based on MN. Participate in Fair hearing process, provide customer svc via Phone Que. THANKS AND REGARDS, ASMA KHAN SURI. Must be able to pass a background and drug screen About BCforward BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers’ needs into a full service personnel solutions organization. BCforward’s headquarters are in Indianapolis, Indiana and also operates delivery centers in 17 locations in North America as well as Hyderabad, India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. With 14+ years of uninterrupted growth, the addition of two brands (Stafforward and PMforward) and a team of more than 1400 resources our teams deliver services for multiple industries from both public and private sectors. BCforward’s team of dedicated staffing professionals has placed thousands of talented people over the past decade, with retention rates that are consistently higher than the industry average.