Texas Licensed Registered Nurse at BCforward in Austin, TX

Company Description

About BCforward BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers’ needs into a full service personnel solutions organization. BCforward’s headquarters are in Indianapolis, Indiana and also operates delivery centers in 17 locations in North America as well as Hyderabad, India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. With 14+ years of uninterrupted growth, the addition of two brands (Stafforward and PMforward) and a team of more than 1400 resources our teams deliver services for multiple industries from both public and private sectors. BCforward’s team of dedicated staffing professionals has placed thousands of talented people over the past decade, with retention rates that are consistently higher than the industry average.

Job Description

Comprehensive Care Program experience highly preferred. The 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 by utilizing the applicable rules of the Texas Administrative Code (TAC), Texas Health and Human Services Commission (HHSC) approved medical policy, and industry standards, accurately interpreting benefits and managed care products. They may educate providers on programs or community resources that may benefit the member. The Registered Nurse will work with physicians in interpreting appropriateness of care. Conducts pre-service, concurrent/ retrospective

Additional Information

Must be able to pass a background and drug screen