Job Description

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Title: Clinical Reviewer

Location: McLean, VA 22102

Duration: 3 Months Contract + Extension

Job Description:

Terms of Employment

• W2 Contract, 3 Months
• Location: Remote
• Candidates must reside within the State of Oregon or bordering geographies

Overview

• 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 Skills & Experience

• Bachelor's degree from an accredited college or university in a related field
• 2+ years of experience in Utilization Management or Clinical Review
• 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

Preferred Skills & Experience

• 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

Sincerely,

Preetam Raj

Lead Technical Recruiter

nTech Workforce Inc.

D: 410-505-4857 EXT: 726

E: preetam@ntechworkforce.com

preetam(at)ntechworkforce(dot)com

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