Job Description

Research Nurse Opportunity

Innova Solutions has a client that is immediately hiring for a Research Nurse. Position type: Full time - Contract Duration: 3+ Months Location: Philadelphia, PA

As a Research Nurse, you will:

• Evaluate a member's BH condition through the review of medical records (including medical history and treatment records) to determine the medical necessity for patient's services based on advanced knowledge and independent analysis of those medical records and application of appropriate medical necessity criteria.
• If necessary, directly interact with providers to obtain additional BH information.
• Have authority to commit the company financially by independently authorizing services determined to be medically necessary based on their personal review.
• For those cases that do not meet established criteria you will provide relevant information regarding members' BH condition to the Medical Director for their further review and evaluation.
• Have the authority to approve but cannot deny the care for patients.
• Be responsible for maintaining regulatory compliance with federal, state and accreditation regulations.
• Additionally, acts a patient advocate and a resource for members when accessing and navigating the behavioral health care system.

The ideal candidate will have:

• Minimum of three (3) years of Behavioral Health clinical experience in a hospital or other health care setting.
• Prior Behavioral Health utilization management experience is desirable.
• Have RN, LSW, LCSW, LPC or LMFT licensure.
• Medical management/precertification experience preferred.

Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.

Pay Range*: $43 - $45 per hour

Pay range offered to a successful candidate will be based on several factors, including the candidates education, work experience, work location, specific job duties, certifications, etc.

Benefits: Innova Solutions offers benefits (based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as req)

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