Innova Solutions
Founded in 1998 and headquartered in Atlanta (Duluth), Georgia, Innova Solutions along with its subsidiaries employs over 50,000 professionals worldwide and reports an annual revenue approaching $3.0B. Through global delivery centers across North America, Asia, and Europe, Innova Solutions delivers strategic technology and business transformation solutions to its clients, enabling them to operate as leaders within their fields. Whether it is onboarding a new service, embracing a new consumer device or rolling out a Business Innovation, Innova Solutions will empower your Enterprise to transition to new technologies, embrace new service delivery models and enhance the business value provided by IT. Innova provides a full spectrum of services to plan, prep, and execute a data center migration and the development of workloads that can be moved to… or in-between, cloud service providers.
A client of Innova Solutions is immediately hiring for a Care Management Coordinator/RN Position type: Contract/Full time Duration: 3+ Month Location: this is Remote position- Philadelphia Pennsylvania 19103 United States Shift: 8:00 AM-4:00 PM (40 hours per week, 8 hours per day) Position is remote - candidate must reside in the tri-state area (PA, DE, NJ)
Review clinical documentation and apply medical necessity criteria Authorize services; refer non-compliant cases to Medical Director Coordinate discharge planning and alternative care settings Ensure benefit coverage and regulatory compliance Document decisions and maintain accurate system data The ideal candidate will have: Education: Active PA RN license; BSN preferred Experience: 3+ years NICU experience; discharge planning or UM experience preferred Skills: Strong clinical judgment and communication Proficient in Microsoft Office, SharePoint, Adobe Knowledge of current medical practices and utilization review tools
Evaluate medical records to determine medical necessity for services using InterQual and other clinical guidelines. Authorize care, collaborate with providers, and ensure compliance with federal, state, and accreditation standards. Act as a patient advocate and resource.
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