Scalence L.L.C. · 1 day ago
PA Clinician
Scalence L.L.C. is seeking a PA Clinician to work remotely in Austin. The role involves conducting pre-service and concurrent retrospective reviews, collaborating with healthcare providers to promote quality member outcomes, and ensuring medically appropriate and cost-effective care.
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 work 10A to 7P shift
Availability for all shifts between 7am and 7pm
Conduct pre-service, concurrent retrospective reviews
Collaborate with healthcare providers
Promote quality member outcomes
Optimize member benefits
Promote effective use of resources
Ensure medically appropriate, high quality, cost effective care
Assess medical necessity of outpatient services
Assess out of network services
Assess appropriateness of treatment setting within scope of professional limitations
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.
Funding
Current Stage
Late StageCompany data provided by crunchbase