Senior Review Coordinator RN - Remote

Overview

As a Senior Review Coordinator, you will be responsible for conducting utilization review/medical management for all services including training and mentoring other team members and performing preliminary research on requested topics.

In Short

• Conducts utilization review/medical management for all services.
• Trains and mentors team members and physician reviewers.
• Performs medical record reviews and provides technical assistance.
• Documents review results in workflow documentation systems.
• Assists in compliance reporting.
• Coordinates peer-to-peer reviews and appeal processes.
• Works independently and in a team in a fast-paced environment.
• Requires a degree in healthcare or nursing.
• 3-5 years of experience in a clinical environment.
• Knowledge of URAC standards preferred.

Requirements

• Four-year degree in health care or relevant experience.
• 3-5 years of recent clinical experience.
• Good written and oral communication skills.
• Ability to work independently and as part of a team.
• Ability to travel 5% locally or overnight.
• Utilization Management experience highly preferred.
• HCBS waiver experience highly preferred.
• Knowledge of URAC standards preferred.

Benefits

• Competitive salary and benefits package.
• Opportunity for professional development.
• Flexible working hours.
• Supportive team environment.
• Remote work options.