Concurrent Review Specialist

2 days ago


Remote, Oregon, United States Monogram Health, Inc Full time $60,000 - $120,000 per year
Position: Concurrent Review Specialist

The Concurrent Review Specialist (CRS) II is a key clinical role within the CRS Team following high risk readmissions and obtaining timely clinical updates to drive inpatient outcomes. The CRS II is responsible for quick interventions to influence discharge planning and prevent readmissions. The CRS II will serve as a liaison to the CRS Team for all readmission related topics.

The CRS II is responsible to work and collaborate with market Clinical Performance Managers, Medical Directors and Care Managers to facilitate discharge plans. The CRS II 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.

Responsibilities
  • Initiate and actively participate in multidisciplinary discharge rounds as needed.
  • Conduct telephonic outreach to high-risk members to complete post discharge assessments, targeted disease management assessments and periodic check-ins.
  • Identify, track, and follow Monogram members at high-risk for hospital admission/readmission.
  • Complete Peer 2 Peer request as need 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
  • The position will be located in the company's Tempe, AZ or Brentwood, TN office or within the region assigned.
  • Active RN License
  • 5+ years' experience in healthcare/health insurance industry, with strong preference for at least 2+ years in case management
  • Excellent verbal communication skills both in person and on the phone
  • Capacity to support the CRS and Operations team in promoting program development and change.
  • Sharp clinical documentation skills
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 – Paid holidays, flexible vacation time/PSSL, and paid parental leave
  • Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
About Monogram Health

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person's health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient's healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health's personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.

Licenses & Certifications

Preferred

  • Registered Nurse

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.



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