Scalence L.L.C. · 3 days ago
PA Clinician
United States
Full-time
Remote
Mid Level
$40.74/hr - $40.74/hrScalence L.L.C. is seeking a PA Clinician to conduct pre-service, concurrent retrospective reviews. The role involves collaborating with healthcare providers to ensure quality member outcomes and optimizing the use of resources while assessing the medical necessity of services.
Information Technology & Services
Responsibilities
Registered Nurse conducts pre-service, concurrent retrospective reviews
They will collaborate with healthcare providers to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources
They will ensure medically appropriate, high quality, cost effective care through assessing the medical necessity of outpatient services, out of network services, and appropriateness of treatment setting within the scope of professional limitations
Qualification
Required
Registered Nurse
Ability to conduct pre-service, concurrent retrospective reviews
Collaboration with healthcare providers to promote quality member outcomes
Ability to optimize member benefits
Promote effective use of resources
Ensure medically appropriate, high quality, cost effective care
Assess medical necessity of outpatient services
Assess appropriateness of treatment setting within scope of professional limitations
Availability to work 10A to 7P shift
Ability to work 8 hour shifts unless OT is needed and approved
Availability for shifts between 7am and 7pm
Company
Scalence L.L.C.
In today’s dynamic and competitive market, success hinges on mastering three key areas: Data Intelligence, Business Resilience, and Digital Experience.
501-1000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase