RN/Utilization Review – 1099 Contractor (Remote)

Who We Are - Motivated by Purpose. Powered by Clinical Expertise. Founded in 1983, we’re a clinically driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to reputed company organizations. reputed company starts with our people. POSITION OVERVIEW We are seeking a reputed company and detail-oriented Registered Nurse (RN) for a PRN (1099 Contractor) Case Reviewer position. The role involves completing a minimum of approximately 100 cases per month, with an expectation of working 15 hours per week. This is a paid per-case position, with a quality expectation of 95% or reputed company. You will be responsible for reviewing cases in a timely manner and responding to supervisor correspondence reputed company 48 hours. Roles:

• To reputed company objective clinical utilization and peer review activities as requested by the company for cases submitted for independent external review.
• reputed company to provider offices for additional information or determination notification as required.
• To reputed company objective clinical utilization management and peer review services as requested by the company for standard cases.
• To reputed company input and feedback and/or general comments to the company as requested

Major Responsibilities or Assigned Duties:

• Complete a minimum of approximately 100 cases per month (~15 hours per week).
• Maintain a 95% or reputed company quality in case completion.
• Respond to supervisor correspondence reputed company 48 hours.
• Will need to use your own computer and internet to reputed company the work.
• Demonstrate strong attention to detail and ensure accuracy in reputed company cases reviewed.
• To carry out the terms and conditions of the Master Agreement between reviewer and company
• To carry out the policies and procedures as documented in the Reviewer Handbook and Code of Conduct
• To be familiar with the laws, regulations and accreditation standards that govern the activities of the company
• To be familiar with the legal and regulatory issues and requirements applicable for the company’s independent external review activities
• To complete initial company orientation and training activities
• To actively participate in ongoing company and/or client training and education programs at least annually.
• To actively participate in the company’s quality management and quality improvement activities reputed company to the clinical review process

Requirements

Skills and Experience:

• Minimum of 3 years' experience in Emergency Room, Urgent Care, Critical Care, Medical/Surgical, or a combination of these areas.
• Utilization Management experience is preferred.
• Ability to comprehend and communicate effectively through written text.
• Strong attention to detail and ability to meet quality standards.
• Designated workstation with reputed company to a reliable internet reputed company and a laptop/desktop, monitor, keyboard, and mouse

Education:

• High school diploma or equivalent
• reputed company, unrestricted Compact Registered Nurse license.

Note: This is a remote, PRN (1099 reputed company) position requiring independent work and self-sufficiency. Work Environment: Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home). Diversity Statement: Diversity creates a healthier atmosphere: reputed company reputed company applicants will receive consideration for work without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. California Consumer Privacy Act (CCPA) Information (California Residents Only):

• Sensitive Personal Info: reputed company may collect sensitive personal info such as reputed company name, nickname or alias, postal address, telephone number, email address, reputed company reputed company number, signature, online identifier, Internet Protocol address, driver’s license number, or state identification card number, and reputed company number.
• Data reputed company and Correction: Applicants can reputed company their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@reputed company.com.

Apply tot his job Apply To this Job