Job Description
Clinical Reviewer Location Remote in Oregon :
Job Title - Clinical Reviewer Job Location - Remote Duration - 3+ Months Pay Rate - $43/hr. on w2 with no benefits
:
The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness.
Responsibilities:
- Assures accuracy and timeliness of all applicable review type cases within contract requirements
- Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department
- In collaboration with Supervisor, responsible for quality monitoring activities
- Maintains current knowledge base related to review processes and clinical practices
- Functions as providers' liaison for customer service issues and problem resolution
- Performs all applicable review types as workload indicates
- Fosters positive and professional relationships with internal and external customers
- Attends training and scheduled meetings for current/updated information
- Cross trains to provide flexible workforce to meet client/customer needs
- Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
Required Qualifications
- Active and unrestricted Registered Nurse (RN) license for Oregon
- Ability to be licensed for the State of Nebraska, if you don't currently hold a compact license
- Bachelor's degree from an accredited college or university in a related field
- 2+ years of experience in Utilization Management or Clinical Review
Preferred Qualifications
- Case management experience
- Knowledge of medical records, medical terminology, and disease processes
- Strong clinical assessment and critical thinking skills
- Excellent written and verbal communication skills
Job Types: Full-time, Contract
Pay: $43.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Experience:
- Clinical Reviewer: 1 year (Required)
License/Certification:
- RN License of Oregon (Required)
- BLS Certification (Required)
Work Location: Remote
Job Tags
Hourly pay, Full time, Contract work, Remote work, Flexible hours, Shift work, Day shift, Monday to Friday,