Position: Concurrent Review SpecialistThe
ConcurrentReview Specialist (RN) is a key clinical role within the CRS Team following high risk readmissions and obtaining timely clinical updates to drive inpatient outcomes. The CRS is responsible for quick interventions to influence discharge planning and prevent readmissions. The CRS will serve as a liaison to the CRS Team for all readmission related topics.
The CRS is responsible to work and collaborate with market Clinical Performance Managers, Medical Directors, and Care Managers to facilitate discharge plans. The CRS will take ownership of company-wide key performance indicators around hospital admission prevention and readmission reduction initiatives. This includes attending daily post hospital discharge visit meetings, tracking Monogram members at high-risk for readmission, and conducting telephonic outreach to facilities and members to complete targeted assessments aimed at reducing future hospitalization. The position will be located in the company's Tempe, AZ or Brentwood, TN office or within the region assigned.
Responsibilities- Initiate and actively participate in multidisciplinary discharge rounds as needed.
- Conduct telephonic clinical review of high-risk members.
- Identify, track, and follow Monogram members at high-risk for hospital admission/readmission.
- Complete Peer 2 Peer request as needed and ensure that all decisions and recommendations are executed.
- Develops and collaborates with market leaders and care managers on members post discharge care transition plan.
- Support Monogram Health as necessary with any tasks or projects required to deliver excellent personalized kidney care and perform all other duties as assigned.
Position Requirements- Active and unrestricted Registered Nurse license
- Minimum of five (5) years of experience in healthcare/health insurance industry, with strong preference for at least two (2) years in case management
- Demonstrated verbal communication skills both in person and on the phone
- Capacity to support the CRS and Operations team in promoting program development and change.
- Proven clinical documentation skills.
CompensationThe base salary range for this role is $80,072 to $96,836 and reflects the range of experience and qualifications we may consider. Final compensation will be determined based on geographic location and job-related factors such as experience, skills, education, certifications, and internal compensation considerations. While a larger range is posted, most offers will typically fall within a narrower band based on these factors.
Benefits- Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
- Financial & Retirement Support - Competitive compensation, 401k with employer match, and financial wellness resources
- Time Off & Leave - 20 PTO days, 7 paid holidays, and 1 floating day to make your own, and paid parental leave
- Wellness & Growth - Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
