Concurrent Review Nurse

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical necessity for members admitted to the hospital. The primary goal is to advocate for and protect members from unnecessary hospital admissions. This role requires following various procedures and processes to complete authorizations successfully. The nurse will collaborate with a team of nurses and communicate with doctors and case managers to make informed decisions and gather additional information about the member’s condition.

Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital admissions. Follow established procedures and processes to complete authorizations. Collaborate with a team of nurses to assist each other and complete cases. Communicate with doctors and case managers to make decisions and obtain additional information about members' conditions. Utilize multiple resources to ensure the successful completion of cases.