Executives-Clinicians-Nurses-PHRN
- Responsible for the review and evaluation of clinical information and documentation, fax triage and conversion, and provider calls.
- Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality
- Data gathering requires navigation through multiple system applications.
- Active PRC - RN License
- With at least 1 year hospital bedside experience
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