NeverHard

Clinical Navigator (Remote) at CareFirst — NeverHard

Clinical Navigator (Remote) at CareFirst in Highlandtown, Baltimore. Skills: Care Management, Clinical Planning, MCG/InterQual, RN, Utilization Management. Apply on NeverHard.

Company
CareFirst
Location
Highlandtown, Baltimore
Type
full_time

Required skills:

Resp & Qualifications PURPOSE: The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience and skills in both care management and utilization management, the Clinical Navigator will leverage proficiency in established MCG, in addition to administrative/regulatory considerations, to determine medical necessity, appropriate level(s) of care, and case managemen…